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Forms



Clients of Victims Services and their representatives are advised that the new online applications forms are now available. 

There are many new features added to the new form including;

  • The new online form provides clients the ability to attach documentation to their application upon lodgement removing the need to email or post this information separately and from the comfort of your PC or mobile device

  • Clients have the ability to select the financial assistance categories they seek and provide supporting documentation such as invoices, quotes upon lodgement

  • Clients can now save the form and return to it before lodging 

  • The online forms are now available for use on all mobile devices ensuring a greater flexibility for clients and representatives 

We appreciate your patience during these upgrades.

If you are experiencing issues accessing our online forms please click here.

Online forms

Note: Online Forms are compatible with Google Chrome, Safari, Mozilla Firefox and Internet Explorer 11 or greater.

Application Form for Primary Victims

https://vsconnect.force.com/vsapplications/s/primary-victim-claim

Application Form for Counselling

https://vsconnect.force.com/vsapplications/s/claim-counselling-only

Application Form for Support for a Family Member of a Homicide Victim 

https://vsconnect.force.com/vsapplications/s/family-victim-application

Application form for funeral expenses by a Funeral Director 

https://vsconnect.force.com/vsapplications/s/funeral-expenses-application

Application form for forensic cleaning expenses 

https://vsconnect.force.com/vsapplications/s/forensic-cleaning-expense-application

Immediate needs support package

Immediate needs support package

Fact sheet/application form for immediate needs support package (PDF, 184Kb)

Use this fact sheet/application form to apply for a grant of financial assistance for immediate needs following domestic violence. Note: please ensure you have also submitted an Application form for primary victims.

Miscellaneous

Service Complaints Online Form

https://vsconnect.force.com/vsapplications/s/victims-services-complaints

Charter Complaints Online Form

https://vsconnect.force.com/vsapplications/s/charter-complaints

Charter of Victims Rights downloadable complaint form (PDF 257Kb) 4pp form

Information about making a complaint under the Charter of Victims Rights (PDF 164Kb)
2pp guide

The Charter of Victims Rights sets out 18 rights which outline how government departments should treat and assist you if you are a victim of crime. Victims Services has a responsibility to receive complaints and to try to resolve th​em. The Charter Complaints webpage explains what you can do if you feel that your rights have not been met.

Information on requesting an internal review (PDF, 114Kb)
(2pp form)

If you received a decision from Victims Services regarding an application for victims support that you disagree with you can request an internal review of the decision by filling out this form.

Government-funded organisation reports (Guide and Form) (PDF, 120Kb) (1pp guide, 2pp form)

The Government-Funded Organisation form may be used to support victim claims made after 14 January 2019. Please read the guide on page 1 of the above document for more information.

Authorising a person to enquire or act on your behalf (PDF, 86Kb)
(1pp form)

Use this form to authorise someone to act on your behalf, to make enquiries and to receive written communication in relation to an application.

Medical information release form (PDF, 121Kb)
(1pp form)

Use this form to hereby give consent for Victims Services to contact health professional/s listed to obtain any reports, clinical notes or other relevant medical information to determine any entitlement to support.

Restitution

Have you been convicted of an offence? You may have to pay restitution (PDF 190KB)
(DL brochure)

Notice of objection to a provisional order of restitution (PDF, 77Kb)
(1pp form)

Affidavit of financial circumstances (PDF, 103Kb)
(2pp form

Application to pay amount of restitution by arrangement or by instalments (PDF, 148Kb)    
(2pp form)

Restitution payment options application (PDF, 119Kb)
(1pp form)

Direct Credit Authority (PDF, 107Kb)
(1pp form)

If you have difficulty downloading any forms please contact Victims Services.

All our forms require Adobe Reader (8.01 or above) to be installed on your computer. The free Adobe Reader software can be downloaded from the Adobe website.