Restorative Justice Unit Referral Form - I am the person who caused harm (offender)

Referral Information
Do you need help to communicate with us? This could include using an interpreter, assistive technology or receiving information in an alternative format.*

NoYes
Select all that apply

Large print or another accessible digital format for documentAuslan interpreterEasy-read or plain English informationTranslated materials or a translator required (please let us know what your first language is)Communication partner or assistantSensory sensitivitiesOther
Please specify your first language*

Further information
Are there any conditions/court orders in place that might prevent a restorative justice process?*

NoNot sureYes
Please specify*
Please provide a brief explanation as to why you would like a restorative justice process to take place. This could include your desired outcomes. *

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Please include any other information that may be relevant for this referral. This could include any concerns or queries you have. *

0/300
Please confirm you are human by writing what you see in the image in the box below*
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