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Crime Victim Assistance Referral Form

Please note: This page is for Victim Advocates within the 18th Judicial District of Arapahoe, Douglas, Elbert, and Lincoln counties only.

  • Complete this form to refer a client for financial assistance.
  • Advocates will work directly with a resource navigator who will determine eligibility.
  • If the form gives you an error, please contact a Resource Navigator by email or phone.
  • Please note: Due to the overwhelming number of requests for assistance, we appreciate your patience in waiting for a response from our team.

Referring Party

Potential Client

Incident Information

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