Page Contents Main Content I am completing this form* On behalf of myself On behalf of someone else Please note consent must be provided if you are completing the form on behalf of someone else. Victim details First name* Last name* Date of birth* Gender* - Select -MaleFemaleNon-binaryPrefer not to say Your details First name Last name Relationship to victim - Select -ParentLegal guardianSupport person I confirm that I am making this request on behalf of the victim-survivor and they have given me their free and informed consent to do so. Yes No You cannot submit this request without consent from the victim-survivor. The QPS acknowledges some victim-survivors may not want a review of a QPS decision and therefore may not give their consent. It is important the victim-survivor is given choice and control. Please ensure you obtain consent before any request is submitted. Matter details Police Report Number Name of investigating officer (if known) Name of offender Contact details Required contact details Select all that apply. Phone Email Phone Email Include form summary in confirmation email Preferred method/s of contact Select all that apply. Phone call SMS/Text Email Postal letter Address Street address Street address (line 2) Leave blank if not applicable Suburb/Town State - Select -New South WalesQueenslandSouth AustraliaTasmaniaVictoriaWestern AustraliaAustralian Capital TerritoryNorthern Territory Postal Code Do you have any contact requirements? Please include any contact requirements e.g. only call after 5pm, only call on weekdays etc Request details I am requesting this review because The QPS did not charge the suspect/s in this matter The QPS discontinued a charge or prosecution of this matter (e.g. police decided not to move forward with the case) The QPS substantially changed or reduced a charge in this matter (e.g. a charge of 'Rape' was replaced with a charge of 'Sexual Assault') The QPS unfounded the matter (e.g. where there was evidence the offence did not occur) I'm unsure/my reason isn't listed here (other) If you have selected ‘other’, please provide further information on this below. Additional details for the reason for this request: Please note this field is optional, however information provided here greatly assists QPS members when allocating and reviewing this request. Accessibility details Do you need an interpreter when speaking with a QPS member? Yes, I need an interpreter No, I do not need an interpreter Which language do you need an interpreter for? Do you have any accessibility measures you would like us to know about? E.g. meeting space must be wheelchair accessible, all information to be provided in Easy English etc Yes, I have accessibility measures/reasonable adjustments No, I do not have any accessibility measures/reasonable adjustments If you selected yes, please provide details: How did you hear about the QPS Right to Review policy? How did you hear about the QPS Right to Review policy? Please selectThe investigating officerThe QPS websiteMy support service workerThe police prosecutorOther (please specify) Privacy I have read and understand the Online Privacy Notice CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Sidebar Content Close tray Contact details Quick links Share page Quick links Download paper form Sexual Violence Right to Review Right to Review Policy Right to Review Policy FAQ's Share this page
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