Confidential Address Program Enrollment Form for Domestic Violence Survivors

Confidential Address Program Enrollment for Domestic Violence Survivors

If you or someone you know is a survivor of domestic violence, sexual assault, stalking, or human trafficking, maintaining a confidential address can be a matter of safety. This Confidential Address Program (ACP) Enrollment Form provides a secure, dignified way to apply for address protection services that help keep your location private from abusers.

What is the Address Confidentiality Program?

The Address Confidentiality Program is a state-level initiative designed to protect survivors by providing a substitute mailing address. Once enrolled, participants receive a designated safe address that can be used for voter registration, driver's licenses, school enrollment, and other public records—keeping your actual residential address confidential and out of public databases.

Why Use Paperform for ACP Enrollment?

Paperform is trusted by government agencies, nonprofits, and advocacy organizations to handle sensitive intake processes with care. This template is built specifically for public administration teams, victim services coordinators, and election officials who need to:

• Protect survivor privacy with secure, encrypted form submissions and SOC 2 Type II compliance
• Streamline eligibility screening with conditional logic that adapts questions based on survivor circumstances
• Reduce administrative burden by collecting all required documentation, consent signatures, and contact preferences in one place
• Integrate with case management systems using Paperform's native integrations or Stepper workflows to route applications, trigger follow-ups, and coordinate with law enforcement or social services

Unlike static PDFs or email chains that expose sensitive information, Paperform lets you create a confidential, accessible enrollment experience that meets survivors where they are—online, on mobile, or embedded directly into your agency website.

Who Should Use This Template

This form is designed for:

• State and local government agencies managing Address Confidentiality Programs or Safe at Home initiatives
• Victim advocacy organizations and domestic violence shelters helping survivors navigate enrollment
• Election officials coordinating confidential voter registration for ACP participants
• Public sector case managers and social workers supporting survivors in securing safe housing, education, and legal services

Whether you're a public administrator, victim services coordinator, nonprofit director, or community advocate, this template gives you a professional, secure starting point that respects survivor autonomy and urgency.

Key Features of This Template

• Eligibility and safety screening questions to assess survivor needs and risk level
• Secure personal information collection including current address, relocation plans, and contact preferences
• Consent and authorization fields for program participation, information sharing, and third-party notifications
• eSignature integration with Papersign to collect legally binding consent without requiring in-person appointments
• Multi-page layout for clear, trauma-informed navigation through sensitive topics
• Conditional logic to show or hide questions based on survivor circumstances (e.g., minor children, ongoing court cases)
• File upload fields for supporting documentation such as protective orders, police reports, or advocacy letters

Automate Follow-Up with Stepper

Once a survivor submits their enrollment application, time is critical. Use Stepper, Paperform's AI-native workflow builder, to:

• Automatically notify case managers or program coordinators when a new application is received
• Send confirmation emails with next steps and safe contact instructions
• Route applications to legal aid, housing assistance, or counseling services based on needs indicated in the form
• Update CRM or case management systems like Salesforce, Monday.com, or Airtable without manual data entry
• Trigger follow-up check-ins at key milestones (e.g., 30 days after enrollment, before renewal deadlines)

Compliance, Security, and Trust

Paperform is SOC 2 Type II certified and GDPR compliant, with data residency controls and role-based permissions to ensure sensitive survivor information is protected at every stage. For government agencies managing ACP programs, this means you can confidently collect, store, and share data in line with state privacy laws and federal guidelines.

All form submissions are encrypted, access is logged, and you maintain full control over who can view, edit, or export survivor information. Paperform also supports SSO (Single Sign-On) for teams that need centralized authentication across multiple public sector tools.

Customization for Your Jurisdiction

Every state's Address Confidentiality Program has unique eligibility requirements, documentation standards, and renewal processes. With Paperform's doc-style editor, you can easily adapt this template to match your jurisdiction's specific rules:

• Add or remove fields to reflect state-specific forms (e.g., California's Safe at Home, Washington's ACP)
• Update language to align with local statutes and terminology
• Embed your agency branding, logos, and contact information
• Adjust conditional logic to account for differences in eligibility criteria (e.g., inclusion of judges, legislators, or reproductive healthcare workers in some states)

Accessible, Trauma-Informed Design

This template is built with trauma-informed principles in mind, using clear, plain-language questions that respect survivors' dignity and autonomy. The multi-page layout prevents information overload, and optional fields give survivors control over what they choose to disclose. Mobile-responsive design ensures survivors can complete the form safely from any device, at any time.

Get Started Today

Whether you're launching a new Address Confidentiality Program or improving an existing enrollment process, this Paperform template gives you a modern, secure, and survivor-centered solution. Start with this template, customize it to your needs, and connect it to your existing case management and notification workflows—all without writing a single line of code.

Paperform is trusted by over 500,000 teams worldwide, including government agencies, nonprofits, and advocacy organizations committed to protecting vulnerable populations. With 30,000+ designer templates, robust integrations, and a platform built for professional, compliant workflows, Paperform is the smart choice for public sector teams that care about safety, efficiency, and dignity.

Note: This form template is designed for address confidentiality program enrollment and is not a substitute for emergency intervention. If you or someone you know is in immediate danger, please call 911 or the National Domestic Violence Hotline at 1-800-799-7233.