CITRC may receive referrals from sources including but not limited to hospitals, local/federal prosecutorial offices, local/federal law enforcement agencies, traditional victim serving agencies and other mental health agencies.

For your convenience, referral forms are available for download hereThe referring agent may complete the form and submit to CITRC at or contact staff and he/she will complete the referral information. 



Monday - Friday:  8:00am - 4:30pm Call the CITRC Administrative Office at 515.244.5372

Evenings and weekends:  Call 515.339.2535 or submit via email at


Referrals are appropriate if the person(s):

  1. Is ≥ 18 years of age

  2. Is a resident of Polk County, Iowa

  3. Is a victim of a violent crime within the last three (3) years

    • Homicide

    • Human Trafficking

    • Sexual Assault, Domestic Assault or Physical Assault 

  4.  Is Uninsured or Underinsured

  5. Has life circumstances that create substantial barriers to accessing mental health services

  6. Is not already receiving mental health services