Victims of Crime QLD - Have you been a victim of crime? You may be entitled to victims assistance from QLD Government.
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Full Name
Safe Address
Phone Number
Email Address
Incident Description
Incident Date & Location
Were you injured in Queensland?
Yes No
Were you injured in the last 3 years?
Yes No
Was it reported to the Police?
Yes No
Did you receive medical treatment?
Yes No
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Victims of Crime Queensland

Complete this victims of crime enquiry form if you have been a victim of crime in Queensland during the past two years and have reported the incident to the police.

Victims of crime in Australia are entitled to financial compensation and support to assist them to recover from the act of violence, including cash lump sum payments for pain and suffering.

Please complete this form with as much detail as you are able to provide and we will contact you promptly.

Enquiry Form

Fields marked with * are mandatory.
Personal Details
Full Name * Date of Birth
Address * Phone *
Safe Address  Email *
Incident Details
Descrbibe incident in details *
Incident date & location Police statement & police details
Offenders details Other victims
Injuries Sustained & Treatment
List physical injuries & treatment
List psychological injuries & treatment
Out Of Pocket Expenses
Indicate any of the following expenses:

Medical, dental, ambulance, hospital, pharmaceutical, loss of income, physiotherapy, psychiatric, psychological, damage to clothing, improved home security, moving home, travelling, other.
List Expenses
Other Relevant History
Prior trauma history Prior medical or psychiatric history
Other comments