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?

    Please enter the text you see below:

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