We're Here to Help

Office Hours: T, W, Th, 9:30 AM – 3:30 PM

NOTE: Must be a resident of Shelby County Indiana.
All new requests for help must fill out the form below.

463-777-5211

Visit to see our privacy policy and Terms of Service."

[LINK]

Your Full Name*

Date of Birth*

Mobile Phone Number*

Street Address*

Apt or lot number

City, State, ZIP*

No. of adults in the home*

No. of children in the Home*

Total household monthly income*

Is anyone in the household a veteran?*

If we can't reach you, can you provide another person we can call?*

Church (former or current)

Please describe your situation*

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Request for Services
and Release Form

Need IMMEDIATE Crisis or Emergency `Support?

If you or someone you know is in immediate danger, experiencing abuse or violence, or you suspect that a child or endangered adult is being abused, neglected, or exploited, please contact the appropriate service below before submitting a request for help.
- Emergency: Call 911 if anyone is in immediate danger.
- Child Abuse or Neglect: Indiana Child Abuse and Neglect Hotline — 1-800-800-5556, available 24 hours a day,
- Endangered Adult Abuse, Neglect, or Exploitation: Indiana Adult Protective Services — 1-800-992-6978.
- Sexual Violence and Abuse Support: RAINN — 1-800-656-HOPE (4673).
- Domestic Violence Support: National Domestic Violence Hotline — 1-800-799-SAFE (7233).
- Suicide and Crisis Lifeline: Call or text 988 for immediate emotional support during a mental health crisis.