Emergency Contact Form

Privileged and Confidential - This form is voluntary and you may leave any questions (except for legal name, date of birth, demonstration location, and NLG assistance) blank.
Some individuals are considered more vulnerable and at higher risk when coming into contact with the criminal justice system. Should you be arrested, we will prioritize jail visits for such folks, please let us know if you fall into one of these categories by checking the below "YES" box. Vulnerabilities include but are not limited to: non-citizens, having serious medical conditions, being gender non-conforming, having a criminal record (particularly if you suspect you may have active warrants), or any other vulnerability.
IMPORTANT: Before self identifying as high-risk, consider that legal support resources are extremly limited and must be reserved for those who are extremly vulnerable — please make this indication carefully. 
HIGH RISK: Should you be arrested, do you want us to prioritize your jail visit? (read above)
Who do you want us to call if there's an emergency? (list up to two people below) PLEASE NOTE: NLG will only release information to Legal Liaisons and individuals listed below as an Emergency Contact.
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