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Apply for financial assistance

Victim Assist Queensland provides access to services and financial assistance to help victims of violent crime recover from the act of violence, including domestic and family violence.

You can apply for our help if the act of violence happened in Queensland. If you have been a victim of violence in another country, state or territory, we can refer you to the relevant jurisdiction’s service.

If you have not already done so, read about what assistance is available and who can apply and how to apply.

It is an offence under the Victims of Crime Assistance Act 2009 to make a statement or provide a document that is false or misleading. We have a zero tolerance to fraud and instances of suspected fraud are investigated and prosecuted as appropriate.

Financial assistance application forms

Download a Victim Assist financial assistance application form below.

Contact us if you need help to complete your application form. When completing the section about 'Out of pocket expenses':

  • you do not need to be specific — it is okay to write things like "I need to see a counselor"
  • you only need to include information about the cost of goods or services if known — if you do not know how much something will cost yet, leave the $ section blank.

Primary victim application form—for a person who has been directly injured by an act of violence in Queensland.

Related victim application form—for a close family member, or financial dependant, of a person who has died, as a direct result of an act of violence that has happened in Queensland (e.g. homicide or dangerous driving causing death).

Funeral assistance application form—for the person responsible for the cost of a funeral for a person who has died as a direct result of an act of violence that has happened in Queensland (e.g. homicide or dangerous operation of a motor vehicle causing death).

Parent secondary application form—for a parent of a child or young person under 18, who has been injured by an act of violence in Queensland.

Witness application form—for a witness who sees or hears an act of violence committed in Queensland.

Optional medical certificate—medical information from a health practitioner may be needed if you are claiming medical or counselling expenses. The medical certificate form may also be used to confirm the act of violence resulted in an injury. If you have existing medical information, you may not need to have this form completed; you can send a copy of other relevant information with your application.

Special applicants

Child or young person (under 18)

The application form needs to be completed by your parent or legal guardian.

If your parent or legal guardian is unable or unwilling to complete the form (including if you are under the care of Child Safety Services), contact us for advice.

If you are more than 12 years and you would like to apply independently, a lawyer can help you with your application. Contact us and we can refer you to a free legal service.

Adult with impaired capacity

If a substituted decision maker has been appointed, such as a guardian, administrator or power of attorney, they should complete the form on your behalf.

If no substituted decision maker has been appointed, but you would like help to complete your form, contact us. We can refer you to a free service to help you complete your application yourself.

Find out more

Quick exit to

Contact Victim Assist

Complete our online information request.


Phone: 1300 546 587 (business hours)

Interpreter assistance

Phone: 13 14 50

Hearing impaired assistance

TTY users phone: 13 36 77 (no additional call charges apply)

Speak and listen (speech-to-speech relay) users phone: 1300 555 727

Internet relay users connect to the National Relay Service.

Last updated
13 July 2017
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