The information requested from you here is the same information we will request from you over the phone. This information will be sent to our staff via encrypted email. We take every precaution we can to protect your information but it is still possible for someone to gain access to this information by using illegal methods. By providing this confidential information via internet you are accepting the risks involved in sending this information to American Women's Services. By submitting this information online you are agreeing not to hold American Women's Services, its employees or agents liable for any damages you may experience as a result of the interception or use of this information.