REQUEST ASSISTANCE FORM

Are you a Priest or Deacon in need of our help?

If you feel that your rights have been violated, please fill in the form below. When you have completed the form, please print it and fax or mail it as indicated below.
This will help us to begin the process of justice for you.

1. In order to better serve you, please provide us with some necessary information. Your privacy is assured!

Name:

Address:

City: State: Zip Code:

Phone

Home: Work: Cell:

Email: Fax:

Diocese/Religious Community:

Year of Ordination:

2. Please give us some background on your family, education, and seminary training:

3. Please describe your years in ministry with some details and reasons why you want our help:

4. Do you have a civil attorney?

Name of Civil Attorney:

Address:

City: State: Zip Code:

Phone

Home: Work: Cell:

Email: Fax:

5. Additional information and details you want to share:

Clear Form:

Submit Form:

Rev. Msgr. Michael Higgins, M.A., S.T.D., J.C.D.

Justice for Priests and Deacons

P.O. Box 87225

San Diego, CA 92138-7225

Phone: (760) 321-4842

Fax: (760) 321-4894

Email: justiceforpriests@verizon.net