Client Intake Form

This page is to be used by SGS staff, Certified facilitators, and trained volunteers

Read Disclaimer:

The information given on this call is a public service and courtesy. This information shall not be construed as legal, medical, or mental health advice.  By continuing with this conversation, you are agreeing that SGS will not be held liable for any action taken because of this call.  SGS reserves the right to report to the proper authorities any incident perceived as a threat or imminent danger to oneself or another person.    

Do you agree to these terms in order to proceed with the call?  

If Client Says No: 

I’m sorry we cannot proceed with this call. If this is a medical emergency, please call 911. If this is a mental health emergency, please call or text 988.



Boys Town National Hotline:


National Domestic Violence and Sexual Assault Hotline:


RAINN (Rape, Abuse & Incest National Network):


Confidential Trafficking Resource Center Hotline:


Omaha Resources:

A problem was detected in the following Form. Submitting it could result in errors. Please contact the site administrator.
Federal Trade Commission (How To Recover Your Hacked Email or Social Media Account)
National Cyber Security (How to recover an infected device):
NE Extortion Statute:
Revenge Porn Statute:
Social Media Usernames:
Do they have an account for collecting money?