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Intake Form / Legal Workshop

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Phone Type
OK to leave messages?
OK to Text?
How did you hear about us?

Confidential Information

This information is helpful for our anonymous reporting to our funding sources and securing grant monies. 

Marital Status
Are you in need of permanent housing?
Are you homeless?
What best describes your living situation?
Employment Status

We want to know how many people are impacted by our help, so we want to know how many people are in your household?

Household Income
Race Self-Identification: (Check all that apply):
Ethnicity Self-Identification: (Check all that apply):
Do you or anyone in your family receive?
Do you or anyone in your family receive subsidized:

Confidentiality Policy*

WE CAN is committed to making this a safe space for all of us.

Our policy on confidentiality states that everything participants share with staff and volunteers is confidential unless a participant shares they are going to hurt themselves or someone else, or if a child, elder or disabled person is being abused or neglected.

Within our groups and workshops, participants will keep confidential all that is shared in the meetings. WE CAN staff reserves the right to ask a participant to leave our programming if we have reason to believe that the confidentiality of the group is violated.

Substance Use Policy*

WE CAN requires that a participant be sober and not use alcohol or drugs on the day of a walk in, appointment, workshop or group. This is necessary for WE CAN to provide a safe space for our programming and events and to support women in recovery as well as women who have been impacted by loved ones who have or had a substance use disorder.

If a participant appears intoxicated or under the influence of drugs, WE CAN will ask the participant to leave the group, workshop, appointment etc and arrange a sober ride home (friend, family, taxi) with assistance from WE CAN.  If a participant leaves the premises while driving a vehicle and appearing intoxicated/under the influence of drugs, the WE CAN staff/intern/volunteer must call the police to notify them with the participant’s name and a description of the vehicle. 

WE CAN staff and volunteers reserve the right to call local Rescue at 911 if we have serious concerns about a participant’s health (including intoxication/under the influence of drugs) to ask Rescue to make an assessment.

COVID Policy

WE CAN requires that masks must be worn in all of our buildings at all times. Anyone who refuses to wear a mask when requested will be asked to leave the premises. We ask that you attend your appointment by yourself, unless you require physical assistance to attend or are unable to secure childcare.

If you are feeling unwell on the day of your appointment, please call our office and we will arrange for the appointment to be held by phone or videoconference. Upon arriving at WE CAN, remain in your vehicle and call our office from the parking lot (at 508-430-8111), and then remain in the vehicle until prompted to enter. No more than two people at a time are allowed in the WE CAN waiting area.

Legal Acknowledgements*

  • The attorney that speaks today is a volunteer in the Legal Program sponsored by WE CAN

  • This workshop is an overview providing general information for educational purposes, not intended to serve as legal advice specific to your situation.

  • We encourage our participants to keep confidential the information shared during the workshop by the other participants; however, WE CAN and the presenters cannot guarantee they will do so and cannot be held responsible in the event of a breach of confidentiality. (Note: You will have the opportunity to ask questions anonymously.)

  • Any responses to questions were given based upon the information you provided.

  • Attendance at this workshop does not create an attorney/client relationship between me and the presenter.

  • I have been told and understand that the attorney leading this workshop may help or may have already helped the adversary in my case without knowing it.

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