Please fill out the form. Once the form is summitted we will review your case and contact you to discuss your options.

Understand that we nay not be able to help you with 100% of the cost.  Once we have determined how much we can help you with we will contact you. 

When filling out your information remember to fill in all the information asked of you. We will contact you if there is any information we will need to complete your request.

Once you have sent us your information you are agreeing that all your information is correct and true.

Please explain in detail your case, so we can better serve you.

Without agreeing to confidentiality you are forfeiting your right for our assistance. Precious Innocence believes all victims have the right to be confidential when telling their story. We ask that whatever you and Precious innocence discuss stays between you and us.

Thank you for putting your trust in Precious Innocence.

Do You Need Assistance?

Relationship to Victim





Assistance Needed





Annual income less the 30,000



Can you verify your income?



Can you verify your case?



Everything is true and accurate.



I agree to complete confidentiality.



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