choosing the right form

To apply for approved counselling or compensation, you need to fill out an application form. In order to select the appropriate form, you need to know whether you are a primary or a secondary victim or a family member of a homicide victim:

primary victim = a person who has sustained injury as a direct result of an act of violence
secondary victim = a person who has sustained injury as a direct result of witnessing the act of violence that resulted in the injury or death of a primary victim, or a parent who sustained injury as a result of becoming aware of the act of violence of which their child (under 18 years at the time of the act of violence) was a primary victim.
family member of a homicide victim = a member of the immediate family of a primary victim who has died as a direct result of an act of violence.

application forms - your options

1. Applications for counselling can be completed and submitted via online web forms, else a pdf version can be downloaded, completed then sent to Victims Services via post, email or fax.
2. Applications for compensation can be downloaded in pdf format. This form should be completed, then printed, then signed, and then posted or faxed to Victims Services. Note that the pdf forms can be filled in electronically and saving the form will also save the information you have entered. (requires Adobe Reader 6 or later).
3. You can contact Victims Services and request that the forms be posted to you.

Primary or Secondary Victim

Initial 2 hours of counselling

• 2hrs initial counselling - secure online form (can be completed and submitted online) OR
• 2hrs initial counselling - non-encrypted online form (for persons who have difficulties accessing the secure version above) OR
• 2 hrs initial counselling - pdf version (267KB) (to download, complete and then send via email, mail or fax)

• Request for Further Hours of Approved Counselling - secure online form (can be completed and submitted online) OR
• Request for Further Hours of Approved Counselling - non-encrypted online form (for persons who have difficulties accessing the secure version above) OR
• Request for Further Hours of Approved Counselling - doc version (11KB) (download, complete and then send via email, mail or fax)

• Application for Compensation and/or Expenses (PDF 229KB) (new form added Mar 07 for claiming compensation and also for claiming expenses under the Victims Assistance Scheme. Note that expenses under VAS can only be claimed by Primary Victims). After downloading, you need to complete, then print, then have signed, and then send or fax to Victims Services. Please also refer to Guide to Completing Your Victims Compensation Application Form
• Injury Nomination Bridging form (PDF 62KB) (for nominating compensable injuries where no nomination was made in the original application for compensation)
• Victims Assistance Scheme (VAS) Supplementary (PDF 80KB) (where the old obsolete Application form for Compensation has been submitted by a primary victim and expenses under VAS are now being claimed, or the new form has been submitted but VAS expenses were not nominated)

Up to 20 hours counselling for family members

• Application for Counselling by Family Members of a Homicide Victim - secure online form (can be completed and submitted online) OR
• Application for Counselling by Family Members of a Homicide Victim - non-encrypted online form (for persons who have difficulties accessing the secure version above) OR
• Application for Counselling by a Family Member of a Homicide Victim - pdf version (36KB) (to download, complete and then send via email, mail or fax)

• Application for Compensation by a Family Member of a Homicide Victim (PDF 232KB) After downloading, you need to complete, then print, then have signed, and then send or fax to Victims Services.

• Application For Funeral Expenses (PDF 33KB) This form is to be used if you are applying for funeral expenses only. If you are applying for compensation and funeral expenses you only need to complete the Application for Compensation by a Family Member of a Homicide Victim.

• Consent Form (PDF 21KB) (To be used for authorising a person to enquire or act on your behalf)

• Defendants who need to pay monies to Victims Services because of a compensation award to a victim can find forms relating to restitution on the ‘Recovering Money’ web page.