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Amani Center
Child Abuse Hotline 877.302.0077

Amani Center

Columbia County Child Abuse Assessment Program

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Forms

CLIENT FORMS

Client History Form (pdf)
Notice of Privacy Practices (pdf)
Release Authorization to Disclose (pdf)
Release of Information (Form 1) (doc) 
Release of Information (Form 2) (doc)

Contact

1621 Columbia Blvd
St. Helens, OR 97051
503.366.4005
Monday - Friday
9am - 5pm

Click To Learn About:

Karly's Law

Address:

PO Box 1001
1621 Columbia Blvd
St. Helens, OR 97051
503.366.4005
Monday - Friday
9am - 5pm

Civil Rights and Non-Discrimination Statement

The Amani Center operates its program, services and activities in compliance with federal nondiscrimination laws. No person shall, on the basis of race, color, national origin (including limited English proficiency), disability, religion, sex, gender identity, sexual orientation, or age, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any of our programs.  The Amani Center is dedicated to an organizational culture of inclusivity.  Civil rights, equality and justice are central to the efforts of our organization.

 

TO FILE A COMPLAINT:

Office of Civil Rights:  To file a complaint of discrimination, write to:

Office for Civil Rights, Office of Justice Programs, U.S. Department of Justice (OCR) ~ 810 7th Street, NW ~ Washington, DC 20531 ~ or call 202-307-0690 (Voice) or 202-307-2027 (TDD/TTY).

Individuals who are hearing impaired or have speech disabilities may also contact OCR through the Federal Relay Service at 800-877-8339 (TTY), 877-877-8982 (Speech) or 800-845-6136 (Spanish)

TO FILE A COMPLAINT:

Amani Center:  To file a complaint of discrimination with this organization, write to:

Amani Center ~ P.O. Box 1001 ~ St. Helens, OR 97051 ~ or call 503-366-4005.

For complaints against employees, you may email Cassy Miller, Executive Director at cmiller@amanicenter.org

Oregon DOJ CVSSD:  To file a complaint of discrimination with Oregon Department of Justice, Crime Victim and Survivor Services Division, write to:

Oregon Department of Justice, Crime Victim and Survivor Services Division ~ Attn:  Shannon Sivell, Complaint Coordinator ~ 1162 Court Street NE ~ Salem, OR  97301 ~ or call 503-378-5348.

You may also email  shannon.l.sivell@doj.state.or.us

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