Referral Form

Christchurch Restorative Services consider referrals from victims, offenders, judges, lawyers, probation officers, police officers, reintegration workers, parole boards, etc. We accept referrals before sentencing, after sentencing and outside the courts.

Offenders acknowledge responsibility for their offending before a referral can progress.

We work with referrals concerning a wide range of offences including environmental pollution, wilful damage, assault, burglary, sexual offending, careless use of a motor vehicle causing injury, rape, murder.

Referral From (required)

Address

Date

Phone

Email

Relationship to Offender


Victim's Name

Address

Phone

Email

Other Victims
YN


Offender's Name

Date of birth

Address

Phone

Email

Offence/s

Plea/s

CRN

PRN

Court

Date of next court appearance

Legal Aid
YN

Co-offenders
YN

If yes have they been referred to us?
YN


Police Officer in Charge

Phone

Email


What do you want from your Restorative Services Conference?

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