Victim Compensation Forms and Publications

Victim service providers: Please use the Application/Bill Status Request Form to request the status of applications or bills that have been submitted to the Victim Compensation Program.

Form names followed by an asterisk (*) can be filled out on-line and printed.

Materials Request Form (Materials are free)

Applications for Victim Compensation

• Application for Crime Victim Compensation

Brochures

• California Victim Compensation Program (General Information Brochure)
• Victim Compensation: Your Right to Appeal
• Restitution for Victims
• Your Restitution Responsibilities (A Brochure for Adult and Juvenile Offenders)
• Heathcare Provider Information Pamphlet

En Español

• Solicitud Para Recibir Compensación por un Delito (Para la Víctima)
• Solicitud Para Dependes o Miembros de la Familia
• Programa de Compensación para Víctimas de California (Folleto de Información general)
• Compensación para Víctimas: Su Derecho de Apelar
• Restitución para Víctimas
• Responsabilidades de Restitución: Un Folleto para Ofensores Adultos y Menores
• El Programa para Ayudar Victimas de Crimen por Causa de Desprecio y Prejuicios Raciales (Planilla de datos)

Forms

General

• Relative Caregiver Affidavit
• Late Reason Consideration Form

Provider Treatment and Billing Forms

• Provider Application/Bill Status Request Form
• Treatment Plan*
• Additional Treatment Plan
• CMS 1500 Form
• CMS 1500 Sample with instructions
• CMS (HCFA) Form 1500 Questions and Answers
• CMS 1450 Form
• CMS 1450 Sample with instructions

Relocation Benefit Forms

• Law Enforcement Relocation Benefit Verification*
• Mental Health Provider Relocation Benefit Verification*
• Relocation Estimate/Worksheet*
• W9 Form
• Rental Agreement

(Related Information Sheet: Relocation, Housing and Shelter Resources for Victims of Domestic Violence and Other Violent Crimes )

Statistical Data

• July 1, 2007 through April 30, 2008
• July 1, 2006 through June 30, 2007

Victim Compensation Connection Newsletter

• Victim Compensation Connection - May 2008
• Victim Compensation Connection - March 2008
• Victim Compensation Connection - January 2008
• Victim Compensation Connection - October 2007
• Victim Compensation Connection - August 2007
• Victim Compensation Connection - June 2007
• Victim Compensation Connection - April 2007
• Victim Compensation Connection - February 2007
• Victim Compensation Connection 2004-2006

Other Publications

Victims

• Victim Compensation Program - Quick Reference Guide

Victim Advocates

• Desk Manual for Victim Advocates
• Application Status Request Form

Law Enforcement

• Law Enforcement Bilingual Card

Relocation

• Information Sheet: Relocation, Housing and Shelter Resources for Victims of Domestic Violence and Other Violent Crimes

Restitution

• California Judges Benchguide
• Quick Reference Sheets on Fines and Orders for Adult and Juvenile Offenders

Mental Health Care for Child Crime Victims: Standards of Care Task Force Guidelines (2001)

Publisher: California Victim Compensation and Government Claims Board (CVCGCB), Victim Compensation Program
Task Force Chairperson: David Chadwick, M.D., Assistant Task Force Chairperson: Michele Winterstein, Ph.D.

This 300-page volume is the result of the efforts of a group of mental health providers and organization representatives who specialize in the treatment of child trauma victims in the State of California. The goal of this group was to produce a set of guidelines that reflect a consensus of the most effective practices for remediating the effects of emotional trauma in child victims of crime. The task force was convened by the CVCGCB; the work of the task force was to address the needs of all victims of child maltreatment.

• Child Crime Victims: Standards of Care Task Force Guidelines (2001)
  

Victims of Hate Crime

• Arabic
• Farsi
• Gujarati
• Punjabi
• Spanish
• Urdu

Victim Witness Centers

• List of Victim/Witness Assistance Centers