Request for Assistance

If you would like to request our assistance, please complete this brief questionnaire. Your submission will be securely transmitted to us, and we will hold this and any information we receive from you as confidential. We give all requests for assistance prompt and full consideration.

What is your name?

What is your relationship to the detained person?

Where are you located?

What is the best phone number at which we can reach you?

What is the best email address at which we can reach you?

Who is detained?

Where are they detained (country, area)?

What entity (government, group, etc.) is responsible for the detention?

When did the person become detained?

Is the detained person a U.S. citizen or legal permanent resident (If yes, indicate which)?

If not, please explain the person’s substantive connection to the U.S.:

Please explain why you believe the person is detained because they are an American:

Are you already in touch with the U.S. government, and if so, what departments or offices?

Are you already in touch with members of Congress (no need to say which)?

Are you satisfied with the attention this case is getting from the U.S. government?

Do you already have parties outside of the family helping with this case? If so, who?

Please provide a short summary of the case:

Your request has been received and forwarded to the appropriate staff member at Global Reach.

We will review your request, and someone will be in touch with you shortly. In the meantime, we recommend that you print and carefully review the Advisory listed on preceding page.

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