This will appear at the top of your completed statement.

We will send your completed statement to this address. You can also use it to save your progress and come back later.

Choose the option that best fits your situation.

An approximate date or year is fine. You do not need to know the exact date.

This may appear in your statement. You can leave this blank if you prefer.

How did you feel when this happened, or in the days and weeks right after?

You might write about what those early days were like for you. Some people describe what was going through their mind, how their body felt, or how their emotions moved from day to day. Others remember very little of that time, and that is just as normal. Write whatever you remember and want to share.

Some people notice changes in how they think or feel. Some don't, or aren't sure. Whatever is true for you is what matters.

If it would help to think it through, you might consider how you've been feeling day to day, and whether anything has shifted since the crime. Some people write about things like anxiety, low mood, trouble sleeping, or feeling on edge. Others write about something harder to name.

If you have seen a psychologist, psychiatrist, or doctor about how you've been feeling, you can mention that. If you've been given a diagnosis or prescribed medication, you can include that too. None of this is required. Write only what feels true and what you want the court to know.

How has this affected your relationships with the people in your life? Some people notice a change here. Some don't. Either way is normal.

If it helps to think it through, you might consider your relationships with your partner, your children, your wider family, your friends, or your community. Some people find that the way they connect with others has changed. Some have pulled away, and others have found certain relationships have grown closer. There is no right answer, only what is true for you.

If the crime was committed by someone close to you, you may also want to write about the impact of losing that relationship. That loss is real, and it belongs here too.

Has this affected your body or your physical health?

You might write about any injuries at the time, or anything that has changed since, like your sleep, your appetite, your energy, or pain that has stayed with you. If you have needed medical treatment or ongoing care, you can include that here.

The way this affects the body isn't always obvious. Some people notice they hold tension, feel run down, or feel less at home in their own skin. If any of that is true for you, it belongs here too. Write only what feels true for you.

Has this cost you money, or affected your ability to work or earn an income?

You might write about lost work or income, the cost of medical treatment or counselling, legal costs, or the cost of moving or replacing things that were lost or damaged. If the offender controlled your money or stopped you from working, describe what that meant for you day to day.

This section can also help if you plan to apply for financial assistance through your state's victims of crime scheme.

How has this changed your day to day life?

This affects people in different ways. For some, daily life looks quite different now. For others, less so. Whatever is true for you is what matters.

If it helps to have a starting point, you might think about the ordinary parts of your day, things like leaving the house, sleeping, concentrating, working, looking after your kids, or spending time with friends. Some people find that parts of daily life have become harder, or that they have stopped doing things that once felt normal. Some find less has changed. There is no right answer here.

How has this changed the way you feel about your safety?

Losing your sense of safety is one of the most serious effects a crime can have, and courts take it seriously. Write whatever is true for you.

You might think about how safe you feel at home, in public, or around other people, and whether that has shifted since this happened. Some people change things in their life because of how they feel now, like where they live or how they get around. If you are still afraid of the offender, or worried something like this could happen again, you can write about that here.

Has this affected your spiritual life, your culture, or your sense of meaning and belonging?

This question is for anyone whose faith, spirituality, or sense of purpose has been affected by what happened.

It is especially relevant for Aboriginal and Torres Strait Islander people. For many Aboriginal and Torres Strait Islander people, harm can affect connection to Country, cultural and ceremonial obligations, community relationships, and spiritual wellbeing in ways the other questions may not cover. If this applies to you, use this space to describe that in your own words. You do not need to use formal or clinical language.

If this question does not apply to you, you can skip it.

Tell us about who you were before this happened. What did your life look like.

This is one of the most important questions in your statement. The court needs to understand what your life was like before, so they can understand what has changed.

You might write about your work, your family, your interests, your personality, or your plans for the future. What did a good day look like? What were you working toward?

You do not have to paint a perfect picture. Just be honest about who you were.