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Request information from Victim Assist

We help victims of crime to get back to normal after experiencing violent crime or domestic and family violence in Queensland.

Our information and referral service is available to help you:

  • find a free counselling service
  • apply for financial assistance
  • understand how to write a victim impact statement
  • find court support.

It takes about 5 minutes to complete this form.

  1. Your details
    1. Name
    4. How would you like us to contact you? *

      Safe contact method

      We need a safe way to contact you during business hours, so provide the safest email address, postal address, mobile phone number or landline number we can contact you on.

      If you provide a mobile number, we may use it to call you or to send a text message.

    6. Postal address (If you chose 'Post' above)
  2. Details of the act of violence
    1. Did the violence happen in Queensland? *
    2. How were you connected to the violent crime? * Select the option that best describes your situation.
    3. What happened? * Select all that apply
    5. Did the violence happen more than once, over a period of time? * Select one
    6. When did the act of violence happen? * (If you chose 'a single incident' above)
      1. Example: mm/yyyy
      1. The violence began * (If you chose 'multiple incidents over a period of time' above)
        1. Example: mm/yyyy
      2. The violence ended * (If you chose 'multiple incidents over a period of time' above)
        1. If the violence is still happening, put the current month and year.Example: mm/yyyy
    8. What information do you need? * Select all that apply

      I want to know...

    4. Privacy statement

    The Department of Justice and Attorney-General (DJAG) is collecting your personal information, including your name, telephone number, email address and information about the act of violence that happened to you, in order to give you information about services to support you. The Victims of Crime Assistance Act 2009 allows or authorises DJAG to collect this personal information. We will only use your personal information for this purpose. It will otherwise not be used or disclosed without your consent unless authorised or required by law. Your personal information will be handled according to the Information Privacy Act 2009 and Human Rights Act 2019.

    If you provide an email address supported by servers outside Australia, and you have asked us to communicate with you using that email address, your personal information will be transferred overseas. If you do not wish to communicate with us by email, phone 1300 546 587 (business hours) or write to Victim Assist Queensland, GPO Box 149, Brisbane, Queensland, 4001.

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Last updated:
13 September 2024
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