Enquiry Form for Forensic Psychological Assessment Reports

Please complete this enquiry form if you are a lawyer or government agency wanting to make a specific enquiry and to obtain an indicative quote for a FORENSIC PSYCHOLOGICAL ASSESSMENT REPORT.

Provide as much detail as possible to help us to determine referral suitability, the type of assessment that will be required and the fee.

We will then review your submitted enquiry form and respond to your enquiry within 5 business days where possible.

Submitting this enquiry form does not constitute making a referral to us and does not mean that we will accept your referral.

Note: We do not provide urgent appointments or urgent reports. We require time to schedule and complete the assessment and then write the report. Once an appointment is booked, the indicative timeframe for the release of a completed report is typically within or about 4 weeks from the date of the assessment, where possible.

Today's date*

Date

I agree to the Privacy Policy and Terms of Use Policy.*

Yes

I have obtained my client's consent to share information.*

Yes

Referrer's details - name of lawyer or representative from government agency*

First NameLast Name

Name of Referrer's legal practice or Name of government agency*

Name of Referrer's legal practice or government agency where Referrer works.

Referrer's email*

example@example.com

Referrer's phone number*

Please enter a valid phone number.

Referrer's address*

Street Address

Street Address Line 2

CityState

Postcode

This forensic psychological assessment report is for a*

Criminal court matterCivil legal matterOther

If you selected Other, please explain briefly.*

What kind of matter is this forensic psychological assessment report for?

Court Type*

Magistrates CourtCounty CourtSupreme CourtOther

If you selected Other, please explain briefly.*

What is the other court type?

Your client is currently*

Not in custodyIn custody

If your client is currently in custody, what is the name of the custody facility?*

Name of the custody facility where your client is located

If your client is currently in custody, what is their CRN?*

Client's CRN

What is the court date for this matter?*

Court date for this matter

Provide details about your client*

Client's First NameClient's Last Name

Client's date of birth*

Client's date of birth

Client's email address

example@example.com

Client's phone number

Please enter a valid phone number.

Client's address

Street Address

Street Address Line 2

CityState

Postcode

Please provide brief details about your client's matter, including the specific allegations/charges against your client.*

What is your client's matter about? What are the specific allegations/charges?

What are the referral questions for the forensic psychological assessment report?*

Some examples: a pre-sentence forensic psychological assessment report for court about the client's alleged mental health conditions and link to offending to inform Verdins sentencing principles; a violence risk assessment of the client's risk of committing future violent offences; a forensic psychological assessment of a parent's mental health and functioning as part of a family law matter, etc.

Does your client have any prior criminal/offending history? If yes, provide details.*

Provide details about your client's prior criminal/offending history.

Does your client have any mental health history? If yes, provide details.*

Provide details about your client's mental health history.

Does your client have any substance use history? If yes, provide details.*

Provide details about your client's substance use history.

Does your client have any violence history? If yes, provide details.*

Provide details about your client's violence history.

Does your client have any history of cognitive impairment, such as suspected or confirmed intellectual disability, acquired brain injury, etc? If yes, provide details.*

Provide details about your client's history of any cognitive impairments.

Are there any factors that could impact on your client's ability to engage in a forensic psychological assessment (e.g., disability, requires an interpreter, cultural issues, etc)? If yes, provide details.*

Provide details about any factors that could impact on your client's ability to engage in a forensic psychological assessment.

How will this forensic psychological assessment report be funded?*

Invoice to the ReferrerInvoice to the ClientInvoice to a Third-Party

If you selected Invoice to a Third-Party, please provide the name of the third-party organisation who will receive the invoice.*

Name of the third-party who will fund this forensic psychological assessment report.

Please verify that you are human*

Thank you for completing this enquiry form.

Please use the submit button below to send your completed enquiry form to us.

We will then review it and respond to your enquiry within 5 business days where possible.