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Welcome to One Safe Place! We understand that making the decision to come here may have been hard and we’re here to support you.

Getting help for yourself and your family members is an important step in securing safety for you, your children, and loved ones.

Staff at One Safe Place – North County Family Justice Center – will collect information during your visits to enhance safety and provide a more effective and efficient service experience. Any information you provide to staff is confidential to the service team at One Safe Place unless any of the following applies:

  • The disclosure is authorized by you.
  • The disclosure is required by any state or federal law (including Brady v. Maryland) and/or the disclosure is required because of a court order.
  • One Safe Place staff have a duty to warn, which refers to the responsibility to disclose what would otherwise be confidential information if you or other identifiable person is in clear or imminent danger; and we will notify the person in danger and others that may be able to protect that person from harm.
  • One Safe Place staff are mandated to report suspected child abuse and neglect. If child abuse or neglect is suspected, we will contact the Child and Family Wellbeing Child Abuse Hotline to make a report.
  • One Safe Place staff are mandated to report suspected elder and dependent adult abuse and neglect. If elder or dependent adult abuse or neglect is suspected, we must contact Aging and Independence Services – Adult Protective Services Hotline to make a report. 
The questions on this form are dynamic - we will only ask what we need to best serve you.
Completing this form takes about 15 minutes.  
Reason for Visit




Tell us about the person primarily needing services today
If you are looking for services for yourself and dependents, please list yourself.  














Tell us about their household









please enter as ###-###-####




























Tell us about the person who harmed you
For your safety, we want to be able to prevent the person who has victimized you from entering One Safe Place when you are here. For this reason, please share the following:












Tell us about the person who harmed your dependent
For your safety, we want to be able to prevent the person who has victimized your loved one from entering One Safe Place when you are here.

For this reason, please share the following:












Safety & Supports 
Your safety is our highest priority. The following questions help us identify any immediate safety concerns. 








DA - 5 











Current Supports 

















One Safe Place Case Management Release of Information
Authorized Consent 

I agree to share the information for the purposes of receiving Case Management services at One Safe Place. With this authorization I am allowing my contact information and case record to be shared with the team of Case Managers at One Safe Place inclusive of staff from Palomar Health Services, Community Resource Center, Women's Resource Center, and SBCS. Consent is not a requirement to receive services, but denial of this authorization would limit your Case Management team to San Diego County District Attorney’s Office (SDCDA) Care Coordinators.







Thank you for sharing how we can best help you today. Last Question - how should we find and greet you: