DISCREET EXHANGE WITH VERBAL ADVOCACY

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Before we begin. Please confirm you understand that the full amount of $195.00 is preauthorized at submission.* This field is required.I understand
I understand
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Please confirm that both you and the person you wish to contact are 18 years of age or older.* This field is required.Submissions that do not meet this requirement are not eligible and will be terminated.
I confirm that both parties are over 18
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Please also confirm you understand this option is consent based, and requires identity disclosure.* This field is required.
I understand
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Has the person ever asked you not to contact them? * This field is required.
YESNO
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If yes, please tell us how and when they said it.* This field is required.
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Are there any legal, safety, or formal rules that limit contact? * This field is required.Examples: restraining order, custody order, court order, HR workplace rule, active legal case.
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Are there any immediate safety risk for anyone involved? * This field is required.If yes, please describe your concerns.
If yes, please describe your concerns.
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What is your full Name* This field is required.
First Name
Last Name
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How would you like us to contact you?* This field is required.Please note, we’ll ask for all contact details later in the form to support verification and safety, even if only one method is used.
Email Exchange as First Step
Text Message Exchange as First Step
Phone Call from Outset
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Phone Number* This field is required.The phone number you want us to contact you on
Please enter a valid U.S. phone number.
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Email* This field is required.The email address you want us to contact you on
example@example.com
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Text Number* This field is required.The phone number you want us to contact you on
Please enter a valid U.S. phone number.
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Your Time Zone* This field is required.
Please Select
Please Select
Eastern Time (ET, UTC −5)
Central Time (CT, UTC −6)
Mountain Time (MT, UTC −7)
Pacific Time (PT, UTC −8)
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Recipient Time Zone* This field is required.
Please Select
Please Select
Eastern Time (ET, UTC −5)
Central Time (CT, UTC −6)
Mountain Time (MT, UTC −7)
Pacific Time (PT, UTC −8)
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Who is this message for?* This field is required.Please enter the name of the person who we will be contacting
Name
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How would you like us to contact them?* This field is required.Please choose one
Email Exchange as First Step
Text Message Exchange as First Step
Phone Call from Outset
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Email* This field is required.The email address of the person we are contacting
example@example.com
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Phone Number* This field is required.The phone number of the person we are contacting
Please enter a valid U.S. phone number.
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How do you know them* This field is required.
Please Select
Please Select
Family
Friend
Coworker
Ex-partner
Neighbor
Other
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What is the status of your relationship with them right now?* This field is required.
Please Select
Please Select
We talk often
We talk sometimes
We do not talk
We are in conflict
We are reconnecting
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Are there any times, places, or methods of contact we must avoid?* This field is required.Example: do not call work, do not contact after 8:00 pm
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In one sentence, what do you want to accomplish with this contact? Example: apologize, set a boundary, ask a question, request a meeting, clear up confusion
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What is the best outcome you hope for? Example: Clear the air, stop conflict, establish contact, end a dispute
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If that does not happen, what outcome is still acceptable to you? Example: “I just want them to hear me,” even if they do not agree.
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Are there any topics to avoid? Example: do not discuss money, do not mention a specific person
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What is the message?* This field is required.Write the exact message you want us to send. An Editor will help refine tone and clarity before anything is sent.
Huge
Large
Normal
Small
Ok
Ok
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What are the 2 to 3 most important points that must be included? * This field is required.Example: You are sorry, amount you are owed
Huge
Large
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Small
Ok
Ok
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What facts do we need to get exactly right? * This field is required.Example: Names, dates, amounts, locations
Huge
Large
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Ok
Ok
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Which parts are your feelings or interpretation, not confirmed facts? * This field is required.Example: I felt ignored, I believed they were upset.
Huge
Large
Normal
Small
Ok
Ok
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Please share a short timeline of what happened* This field is required.3 to 10 bullets, in order. Dates help, but “about last spring” is acceptable
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Large
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Small
Ok
Ok
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What happened most recently that made you decide to do this now? * This field is required.One or two sentences
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Large
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Small
Ok
Ok
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Have you tried to contact them about this before?* This field is required.
Please Select
Please Select
Yes
No
If yes, what did you say, and how did they respond?
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What do you think the other person believes happened?* This field is required.
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Do you have any supporting material you want us to review? * This field is required.Example: one message thread or one key document, only what is necessary.
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Is there a deadline or time sensitivity? * This field is required.If yes, please share the date and why it matters
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What hours are you available when a phone call is needed? * This field is required.Example: Weekdays 9:00 am to 1:00 pm
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Are there any sensitive topics we should handle with extra care? * This field is required.Examples: abuse, addiction, mental health, self-harm, violence, money, custody
Please Select
Please Select
Yes
No
If yes, please note here
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Consent and Agreement* This field is required.Please click the checkbox to proceed
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Discreet Exchange with Verbal Advocacy* This field is required.
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ORDER SUMMARY
Total costUSD
Discreet Exchange with Verbal AdvocacyDiscreet Exchange with Verbal Advocacy builds on the written exchange by adding a live, Editor led conversation. This is used when written communication has created enough progress, or when real time clarification is required from the outset.
$195.00Edit
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Total cost $0.00
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