PROTECTIVE ORDER DEFINITIONS
Respondent -
The party who contends against an appeal; the party against
whom the appeal is taken.
Petitioner -
One who presents a petition to a court, officer, or legislative body. The one who files a protective order.
Restraining order - A legal order issued against an individual to restrict or
prohibit access or closeness to another specified
individual.
Protective Order -
Any order or decree of a court whose purpose is to protect a
person from further harassment or abusive service of process
or discovery.
Indigent -
One who is needy and poor, or one who has not sufficient
property to furnish him a living nor anyone able to support
him to who he 1s entitled to looK for support. Indicates
one who is destitute of means of comfortable sUbsistence so
as to be in want.
Municipality -
A legally incorporated or duly authorized association of
inhabitants of limited area for local governmental or other
public purposes. A body politic created by the incorporation of the people of a prescribed locality invested with
subordinate powers of legislation to assist in the civil
government of the state and to regulate and administer local
and internal affairs of the community.
Contempt -
The tenm is chiefly used with reference to the failure or
refusal of a party to obey a lawful order, injunction, or
decree of the court laying upon him a duty of action.
Failure to do something which the party is ordered by the
court to do for the benefit or advantage of another party to
the proceeding before the Court.
A civil contempt is an offense against the party in whose
behalf the mandate of the court was issued, and a fine is
imposed for his indemnity.
PROTECTIVE ORDERS l
Indiana Code 34-4-5.1
A protective order is an order of the court issued to prevent abuse of a person or property.
WHO MAY FILE A PETmON FOR A PROTECTIVE ORDER?
If you are age 18 or older or an emancipated minor (an emancipated minor is a person under age 18 who has
sought and obtained a coun order under Indiana law freeing him or her from the supervision of his or her parents) you
may file a petition for a prmective order on your own behalf or for a member of your household.
WHERE DO I FILE A PETITION FOR A PROTECTIVE ORDER?
You may file a petition for a protective order in any court unless there is a pending divorce or legal separation
in another court; then, you must file the petition in that court.
HOW DO I GET A PROTECTIVE ORDER?
STEP 1: You must file with the court a petition for a protective order which includes the following
information:
(1) Your name, as the person filing the petition for the protective order (you will be known as the
"petitioner"), and the name and address, if known. of the person against whom the protective order
will be granted (who will be known as the "respondent");
(2) A statement regarding:
a. the date or manner of specific acts or feared acts of abuse (which include condua or
threatened conduct that if completed would cause physical impainnent or pain or
damage to property), harassment or disruption of the peace of your household; or
b. specific damage to or fear of damage to your property;
(3) A request that if the court grants the protective order the court will order the respondent:
a. to stop abusing. harassing or disturbing the peace of the petitioner. by either direct or
indirect contact;
b. to stop abusing. harassing or disturbing the peace of a member of your household, by either
direct or indirect contact;
c. to stop entering your property, including property jointly owned or leased by you and the
respondent. or any other property specifically described in the petition;
d. to stop damaging any of your property;
PLEASE NOTE:
If an emergency exists regarding the relief requested under sections a through d,
above, the petition must also include a statement explaining why the emergency exists
and a request that the court immediately issue an emergency protec;.tive order that
requires the respondent to immediately refrain from doing the acts described.
Under lndiana Code 33-17-1-11. the Attorney General is providing this form to all county clerks for persons filing petitions
for the issuance of a protective order under Indiana Code 34-4-5.1 without the assistance of an attorney.
e. for married couples, where there is no pending case of divorce or legal separation:
(i) to be evicted from your dwelling, if the respondent is not the sole owner or tenant;
(ii) not to transfer, encumber, damage, conceal or otherwise dispose of property
owned jointly by you and the respondent or property that is an asset of the
marriage;
(iii) to pay child suppon;
(iv) to pay maintenance; or
(v) to do any combination of the acts listed in (i) through (iv);
(4) Be sworn to by you;
(5) Include a request that the coun set a date for a hearing;
(6) Include a confidential fonn concerning protective orders approved by the division of state coun
administration, which can be obtained from the clerk; and
(7) MAY include a request that the coun order counseling or other social servicc::s, inciuding douleslic
violence education for you or for the respondent or both.
STEP 2: You must pay the filing fee to the county clerk.
(1) If you can show, by an affidavit, that you are unable to pay the filing fee due to relevant
circumstances, the coun may order the clerk to waive the filing fee.
(2) After the hearing, the coun may order the respondent to pay the ,filing fee.
STEP 3: When you file the petition for a protective order, the coun will issue to the respondent a summons to
appear at the protective order hearing.
STEP 4: Within thiny (30) days from the date you file the petition, the coun must hold a protective order
hearing at which the court will decide whether to issue the protective order. For an emergency
protective order, the court will immediately review the petition, without a hearing, and decide
whether to issue the emergency protective order.
WHEN IS THE PROTECI1VE ORDER EFFECTIVE?
A protective order becomes effective when issued by the court. An emergency protective order becomes
effective upon the date the coun issues it. The coun will then set a date for the protective order hearing within thirty
(30) days from the date you fIled the petition. The emergency protective order expires on the date of the hearing. At
the hearing, the coun will decide whether to issue a protective order.
WHAT CAN I DO IF THE PROTECTIVE ORDER IS VIOLATED?
You should keep a copy of the protective order. Ifthe respondent violates the protective order, ~all the police
:-""'tell them that there is a protective order against the respondent and explain how the respondent has violated the
G . ..;r.
ss\94626-1
'?-STATE OF INDIANA
COUNTY OF MADISON
)
) ss
)
MADISON ------------ COURT-----CAUSE NO __________________
Petitioner
vs
Respondent
PRO SE PETmON FOR LEAVE TO PROCEED AS AN INDIGENT PERSON
I,
• move this court for an order allowing me to
proceed as an indigent person without being required to pay a filing fee.
In support of the foregoing, I have attached my affadavit that I am indigent.
Submitted by,
ProSe
6/1/95 Mad. Co. pro se fonn C-l
IN THE MADISON - - - COURT, DIV.
STATE OF INDIANA )
)55:
COUNTY OF MADISON )
CAUSE NO.
Petitioner
VS.
Respondent
AFFIDAVIT OF INDIGENCY
I,
, being duly sworn, say that the
following is true to the best of my knowledge and belief:
1. I am the Petitioner in this cause of action and because of my poverty
I am unable to make payment of the costs of this proceeding or to give
security for them.
".....
per
a.
My only income is
b.
I am supporting
c.
I have
account number
d.
I own real estate [
e.
I own no personal property other than my clothing and other
personal belongings of minimal value, EXCEPT ______
f.
I have a car [ ] yes
If yes, I drive a
person(s).
Bank under
in
] yes
[
] no
"c...
g.
Cash on hand:
[ ] no.
(year)
(model)
---------
2.
I believe that I am entitled to the remedy sought and that this case
has merit.
3.
In this cause of action, I am seeking a Protective Order for myself
(and my family if applicable).
!
I
4.
I understand that I may be held liable ~o pay Court costs if the
cause is dropped or dismissed.
I
(petitioner's signature)
I
-
I affirm under the penalties for perjury
are true.
th~t the foregoing
representative
(petitioner's signature)
STATE OF INDIANA
~
~OUNTY
OF MADISON
)
) ss
)
MADISON _ _ _ _ _ _ COURT_ __
CAUSE NOo _ _ _ _ _ _ _ _ _ _ __
Petitioner
vs
Respondent
ORDER REGARDING FILING FEES
The Court, having examined the Affidavit of Indigency filed in this protective order case, now orders that
the Petitioner not be required to pay filing fees in this matter.
Date:
--------------------
0---6/1/95 Mad. Co. pro se form C-3
JUDGE
Madison
------------------ Court --------
MADISON _ _ _ _ _ COURT_ _ _ __
DATE: - - - - - - - -
CAUSE NO.
------------------
CONFIDENTIAL
For Use by Court Officials and SherifflPolice ONLY
Information found on this form is CONFIDENTIAL
pursuant to I.e. 35-46-1
- - - Yes
- - - No
(1.) Person Protected (Petitioner)
Name:
Age: _ _ _ _ _ _ _ _ _ _ _ __
Home Address: .
----------------------------
.-
Postal Address (If different from
home address): _____________
This is an amended Confidential form. If yes, date of
previous Confidential Form: _ _ _ _ _ _ _ _ __
Does the protected person live
within a municipal boundary?
(]Yes
(]No
If yes, which municipality:
Telephone No.: (home)_ _ _ _ _ __
(work}________
Discuss when protected person can be
reached at the above telephone numbers
or any alternate numbers: ________
Directions to home if not explicit in address
(2.) Person Restrained (Respondent)
Name:
Age: _________________
Home Address:
Telephone No.: (home)_ _ _ _ _ __
(work)_ _ _ _ _ __
Location of place of business or where
person usually/often found: ________
Postal Address (If different from
home address):
Any scars or tattoos?__________
If yes, where
---------------------------
----------------
----------------
(3.) List tile name(s) and age(s) of any person(s) residing at tile petitioner's ltouse/told:
.-..\J"ame(s): ________________
.'-....-
611195 Mad. Co. pro se form C-OOI
Age(s): _ _ _ _ _ _ _ _ _ ___
STATE OF
INDIfu~A
COUNTY OF MADISON
)
) ss
)
MADISON -------- COURT-----CAUSE NO. _ _ _ _ _ _ _ _ _ __
Petitioner
vs
Respondent
address
PROSE
PETITION FOR EMERGENCY PROTECTIVE ORDER PENDING
HEARING AND FOR A HEARING FOR A FINAL PROTECTIVE ORDER
1.
The Respondent has committed specific acts, or I fear acts, of abuse, harassment or
disruption of my peace, or of a member of my household, as follows:
(A) The Respondent on or about the
day of
• 19- - - - - J did or stated
concerning the Petitioner: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
(B.) The Respondent on or about the _ _ _ day of
, 19- - - - - J did or stated
concemmg
, a member of the Petitioner's
household as follows :
-----------------------------------
(C.) The Respondent on or about the
day of
, 19- - - - - J did damage
or stated threats of damage concerning the Petitioner's property as follows :
(If more space is needed, please continue on reverse side.)
2.
(A.) I am married to the Respondent.
Yes
No
IF MARRIED, answer B, C, and D below. If not ~ proceed to item #3.
(B.) There is a Dissolution ofMarriagelDivorce or Legal Separation pending.
No
- - - -Yes
(C.) Was there a Temporary Restraining Order issued under IC 31-1-11.5-7 that is still in
Yes
No
effect?
(D.) I request the Court to order the Respondent to: (check those applicable)
_____vacate the dwelling of which the Respondent is not the sole owner or lessee
located at
--------------------------
_ _----Cnot transfer, encumber, damage, conceal or otherwise dispose of any property
jointly owned with the petitioner or that is an asset of the marriage.
_ _ _No
I have requested legal assistance from the following:
3.
- - -Yes
4.
I request that the Court order the Respondent to: (check and complete all that apply)
_ _ _ refrain from abusing, harassing, or disturbing the peace of the Petitioner by either
direct or indirect contact.
_ _ _ refrain from abusing, harassing, or disturbing the peace of _ _ _ _ _ _ __
a member of the Petitioner's household by either direct or indirect contact.
_ _ _ refrain from entering the Petitioner's property, which is located at _ _ __
and which said property is NOT solely owned or leased by the Respondent.
_ _ _refrain from damaging any property of the Petitioner.
5.
The Petitioner requests the issuance of an Emergency Protective Order Pending Hearing
for the reason that
-------------------------------------------------
6.
The Petitioner requests the setting of a Final Protective Order hearing in this matter.
7.
The undersigned Petitioner affirms under penalties of peIjury that the above statements are
true.
PETITIONER'S SIGNATURE._ _ _ _ _ _ _ _ _ _ _ __
PRINTED NAME OF PETITIONER._ _ _ _ _ _ _ _ _ __
DATE________________
Prepared by: (This IS ItUIndatory and NOT confidential. If you are concerned about disclosing
your current address on this fonn then please provide an alternate address where you may receive
proper notice of developments in this cause of action. Be sure that the address provided is one
which you are certain to receive any correspondence from the court.
Name:
----------------------------Address:
-----------------------City: _______________________
Phone:
---------------------------
6/1/95 Mad. Co. pro se form C-4
"'uu
A CONFIDENTIAL FORM MUST ACCOMPANY TIDS PETITION
u ...... '"
ST ATE OF INDIANA
COUNTY OF MADISON
)
) ss
)
MADISON _ _ _ _ COURT _ __
CAUSE NO. _ _ _ _ _ _ _ __
Petitioner
vs
Respondent
EMERGENCY PROTECTIVE ORDER PENDING HEARING
issued under I.e. 34-4-5.1-2.3
The Court being duly advised in the premises now finds that there is probable cause to
believe that the Petitioner, a member of the Petitioner's household, or the Petitioner's property
was or is in danger of being abused or threatened with abuse by the Respondent.
,.-.
THIS ORDER SHALL REMAIN IN EFFECT FROM THE DATE OF THE
JUDGE'S SIGNATURE UNTIL THE FINAL PROTECTIVE ORDER HEARING OR
UNTIL FURTHER ORDER OF TIDS COURT. SUCH HEARING IS NOW SET IN THIS
CASEONTHE
DAY OF
,19
,AT _ _ __
O'CWCK
.M. RESPONDENT IS ORDERED TO APPEAR AT THAT DAY AND
TIME.
PARTIES ARE TO REPORT TO HEARING ROOM NUMBER TWO WCATED
NEXT TO THE COURT ADMINISTRATOR'S OFFICE ON THE FOURTH FWOR OF
THE COURTHOUSE. DO NOT REPORT TO SUPERIOR COURT, DIVISION n.
The Court hereby orders that a Protective Order be issued in favor of the Petitioner
against the Respondent and orders the Respondent to :
(all applicable items are checked)
_ _ _refrain from abusing, harassing, or disturbing the peace of the Petitioner by either
direct or indirect contact.
_ _ _refrain from abusing, harassing, or disturbing the peace of _ _ _ _ _ _ __
a member of the Petitioner's household by either direct or indirect contact.
_ _ _.refrain from entering the property, which is located at _ _ _ _ _ _ _ __
_ _ _refrain from damaging the Petitioner's property.
- - -Other: ---------------------------------
The Clerk of this Court shaH provide a copy of this order to each party, the sheriff, and the
law enforcement agency of the municipality (if any) in which the protected person resides. The
Sheriff and the law enforcement agency that receives a copy of this order shall maintain a copy of
this order in the Protective Order Depository pursuant to I.e. 5-2-9.
The Sheriff or other law enforcement officer is hereby ordered to serve this Order upon
Respondent.
Date:
---------------
JUDGE
Madison------------- Court-----
Copies of this Order to be distributed to:
_ _ _ Respondent or counsel, if any
----- Petitioner or counsel of record
____ Mad. County or
County Sheriff for Service
NOTICE TO RESPONDENT
~
A PERSON WHO KNOWINGLY OR INTENTIONALLY VIOLATES TillS ORDER
MAY BE CHARGED WITH THE OFFENSE OF INVASION OF PRIVACY, A CLASS B
MISDEMEANOR PUNISHABLE BY IMPRISONMENT OF UP TO 180 DAYS AND A FINE
OF $1,000.00. (see I.e. 35-46-1-15.1)
A PERSON WHO KNOWINGLY OR INTENTIONALLY VIOLATES A
PROTECTIVE ORDER FOR A SECOND TIME INVOLVING THE SAME PROTECTED
PERSON MAY RECEIVE SENTENCING AS A CLASS A MISDEMEANOR PUNISHABLE
BY IMPRISONMENT OF UP TO ONE YEAR AND A FINE OF $5,000.00.
Pursuant to I.e. 35-33-I-l(a)(6), a law enforcement officer may arrest any person when
the officer has probable cause to believe that such person has violated this protective order.
6/1/95 Mad. Co. pro se form C-5
.:> 1 ~ 1 t
VI' U'<U1JV'U\.
)
IVUL.LI.1...J\JJ. "
--
'-."VUl'-l
) 55
COUNTY OF MADISON
)
CAUSE NO, _ _ _ _ _ _ _ _ __
Petitioner
V5
Respondent
NOTICE OF PROTECTIVE ORDER
"'** A CONFIDENTIAL FORM ( C-OOI ) MIJST BE ATTACHED TO THIS NOTICE "'''''''
Notice is hereby given that the ATTACHED ORDER has been issued under the
provisions ofI.C. 5-2-9:
1.
Protected Person:._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
2.
Restrained Person:,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
3.
Type of Action (check all applicable) :
[ ] Temp. Restraining Order:
Dissolution of Marriage (IC 31-I-I1.5-7(b)(2) and (b)(3)
[ ] Protective Order (IC 31-1-11.5-8.2)
[ ] Emergency Protective Order(IC 34-4-5.1-2)
[ ] Protective Order (IC 34-4-5.1-3)
[ ] Juvenile Crt. Dispositional DecreelInjunction (IC 31-6 et seq.)
[ ] Pretrial Diversion (IC 33-12-1-7)
[ ] Pretrial Release (IC 35-33-8-3)
[ ] Condition of Probation (IC 35-38-2-2)
4.
Service of the Order to be done by:
[ ] Sheriff [ ] Certified Mail [ ] Other _ _ _ _ _ __
[ ] Delivered in open Court on :_ _ _ _ _ _ _ _ _ _ _ __
Hearing set for the _ _ _ _ _ day of _ _ _ _ _ _ _ , 19_ _
(CLERK'S OFFICE USE ONLY)
Mailed or Picked up by_ _ _ _ _ _ _ _ _ _ Dept.. _ _ _ _ _ _ _Date_ __
Mailed or Picked up by
Dept.
Date- - ~ailed or Picked up by
Dept.
Date- - failed or Picked up by
Dept.
Date- - 611195 Mad. Co. form C-7
STATE OF INDIANA
COUNTY OF MADISON
)
)
)
SS:
IN THE MADISON
DIVISION
COURT
PETITIONER
'IS
Cause No.
48 ____________________
RESPONDENT
SUMMONS (PROTECTIVE ORDER)
TO RESPONDENT:
(Name) ___________________________________
(Address) ______________________________
DATE OF HEARING:
DAY OF
, 199__ , AT 9:00 A.M.
MADISON COUNTY GOVERNMENT CENTER, 4th FLOOR
HEARING ROOM B
You are hereby notified that you have been sued by the
person named as Petitioner in the Court indicated above.
The nature of the suit against you is stated in the
Petition which is attached to this Summons.
It also states
the relief sought or the demand made against you by the
Petitioner.
An answer or other responsive pleading is not required.
However, a hearing has been set as shown above and you are
required to appear to answer the petition.
If you fail to
appear at the hearing in the Court indicated above, the
matter may be heard in your absence.
IN ORDER FOR A PROTECTIVE ORDER TO BE MADE MUTUAL--OR
TO BE ENTERED ON YOUR BEHALF AGAINST THE PETITIONER--YOU
MUST FILE A WRITTEN CROSS-PETITION AGAINST THE PETITIONER
NOT LESS THAN SEVEN (7) DAYS PRIOR TO THE HEARING DATE.
CROSS-PETITION FORMS ARE AVAILABLE AT THE OFFICE OF THE
COURT ADMINISTRATOR.
Dated:
Clerk, Madison
Division
Court
The following manner of service of summons 15 hereby
designated:
__ Certified Mail
Personal
Service on Agent __ Publication
.lI "U\'" ,"''':lUI.)UlI '-'VUULJ '-UUIt,
) SS:
)
County of Madison
UIVI~IUll
I
Madison County Government Center (3rd Floor)
16 East 9th Street, Anderson, Indiana 46016
Telephone: (765) 641-9490
NOTICE OF SMALL CLAIM
Cause No. 48EOl-----------SC----------Claim for: ____ Money owed
Name (Plaintiff)
_____ Replevin
(return of personal
property)
Address
Judge:
City
Zip
State
David Hopper
Phone
AGAINST
Name (Defendant)
Name (Second Defendant)
Address
Address
City
State
Zip
Phone
City
State
Zip
Phone
TOmE DEFENDANT(S): You have betn su~by the Plaintiffwhos:c name appears abOve. A brief statement ofPlaintitrs claim against
y,Pl'o-is as follows:
(If based on a written contract or on an account, a copy of the contract or an itemized statement of the account is attached.)
Plaintiff claims you owe (as of the date of filing):
$ ____________
Pre-judgment interest (if claimed and permitted by law):
$ ____________
Attorney fees (if claimed and permitted by law):
$_________________
Other.
$ ______________
SUBTOTAL
$_________________
Court costs (the filing fee paid by plaintifl):
$_ _ _
2--"').--=,0'-'0'---_ _
TOTAL CLAIM OF PLAINTIFF (including court costs)
$ _ _ _ _ _ _ _ __
FILE STAMP
Signature of Plaintiff or Plaintitrs attorney
NOTICE TO APPEAR
Defendant is to appear for
(PRE-TRIAL CONFERENCE)
(TRIAL)
to answer Plaintitrs claim on
_______________________ , 19___ , at __________ (a.m.) (p.m.). Failure to appear may result in a DEFAULT
JUDGMENT being entered against Defendant(s).
IMPORTANT INFORMATION CONCERNING THIS CLAIM
I.
If the Defendant does not dispute the Plaintiff's claim, he or she may appear at the time set for the
pre-trial, confess judgment, and provide information as to how and when the judgment can be paid. Execution on the
judgment shall be stayed automatically by the Court if the Defendant pays toward the judgment at least 15% of net
take-home pay (calculated as gross pay minus taxes and social security).
2.
A trial will be set if the claim is disputed. A continuance of the trial date will be granted only for
good cause shown. Any request for a change of the trial date by either party should be directed to the Court Reporter.
3.
Both plaintiff and defendant should have the cause number available and should refer to it when
communicating with court personnel about the case. When reporting to court for pre-trial, trial, or for any other
reason, both parties must bring their copies of the Notice of Small Claim and any other papers received from the
Court.
The Plaintiff and Defendant may represent themselves individually or be represented by attorneys. If
4.
Plaintiff or Defendant is a corporation, it must be represented by a lawyer on any claim over $1500.00. For claims of
S I 500.00 or less, a corporation, partnership, or sole proprietorship may file with the Court a form (available at the
court) designating a full-time employee as a representative for the business in court.
The Plaintiff and Defendant must bring to trial all documents and other available evidence which
5.
relate to this claim. Witnesses who are unwilling to appear voluntarily may be subpoenaed into court for the trial.
6.
By filing this claim on the small claims docket of County Court I, the Plaintiff no longer has a right
to a trial by jury. The Defendant has ten (10) days from receipt of this notice tofiJe an affidavit requesting ajury trial
_ and otherwise complying with the requirements of Indiana Code 33- I 0.5-7-5, or Defendant also loses the right to a
trial by jury. Defendant with the affidavit must also pay a plenary transfer fee of Seventy Dollars ($70.00). If the
-./ request is granted, the case wiJ) be transferred to the plenary (regular) docket and will lose its status as a small claim.
All fonnal rules of procedure and evidence are followed in cases on the plenary docket, and it is strongly advised that
both Plaintiff and Defendant be represented by attorneys in such a situation.
I
If Defendant has any claim against Plaintiff, he or she may contact the court at the pre-trial
7.
conference or otherwise and file a counter-claim. A counter-claim would be heard at the same time as the trial on
Plaintiff's claim. The counter-claim must be filed so as to give Plaintiff notice of it at least seven (7) calendar days
prior to trial.
8.
A claim settled by out-of-court agreement may be disposed of in two ways: (I) Plaintiff may sign a
fonn dismissing the claim if he or she is fully satisfied. (2) An agreement that a judgment will be entered and paid in
specific installments can be put in writing, signed by both sides, and submitted for the judge's approval. If approved,
the agreement will then become a judgment.
9.
Court personnel are available to assist with questions about court procedures or filling out forms.
Neither the employees nor the judge, however, are permitted to give legal advice (whether to file a claim, whom to
file against, how much to sue for, etc.). An attorney should be consulted regarding legal questions.
10.
FAILURE TO APPEAR. A Defendant who fails to a:>pear for the pre-trial conference or for trial may
have a default judgment entered against him or her at the request of the Plaintiff. Failure of the Plaintiff to appear for
trial will usually result in dismissal of the claim and a judgment for Defendant if a counter-claim has been filed. An
..-alternative to dismissing a case is assessing special costs against the non-appearing party. If a judgment is entered
nd the person owing the debt fails to obey a direct Court order to appear for further hearing, that person will usually
'--'be arrested for contempt of court.
II.
If you have questions about court procedures or the first hearing that has been scheduled in this case,
you may call County Court I at (765) 641-9490.
STATEMENT OF CONFIDENTIALITY
I understand that all names and information about clients of
Anderson City Police Department are to be held in the strictest
confidence.
I swear/promise not to disclose any information
regarding the same to unauthorized sources or persons.
Signed
Date
ANDERSON POLICE DEPARTMENT
~..
VICTIM ADVOCACY PROGRAM
CLIENT RELEASE OF INFORMATION
The client has the right to authorize or to deny authorization for disclosure of information to specific individuals and/or
agencies.
This express right to authorization for disclosure does not
apply in the following circumstances:
1.
when information is pertinent to the case and will be
passed to the investigating officer
2.
in the event of a valid medical emergency
3.
when information is requested by the courts/or other
legal proceedings
•
when there is reason to believe a child has been the
victim of child abuse or neglect
~.
:>.
when a client threatens suicide and/or is a danger to
self
6.
when there is reasonable suspicion that a client is a
danger to another person.
~.
;-...
I hereby authorize THE VICTIM ADVOCATE OF THE ANDERSON POLICE
DEPARTMENT to disclose
(specific information to be disclosed)
concerning
(name of client)
to
(name of person/agency to which disclosure is to be made)
I understand that this statement of consent may be revoked at any
time by me upon written request.
5ignature ________________________________________.Date ________________
statfjWitness Signature
---------------------------Date--------------
VICTIM ADVOCATE
CONFIDENTIALITY POLICY
Victim Advocate: The Victim Advocate shall keep all information confidential
in the performance of her duties. Whenever helpful information is gained
concerning an 1nvestigation, it shall be the responsibility of the Victim
Advocate to forward this information to the appropriate investigator. The
Victim Advocate will only discuss client information with officers involved
with the case or appropriate supervisors.
Victim: The Victim Advocate's responsibility is to provide assistance and
support to victims of crime. In the event a victim requests information to
remain confidential, it will be the position of the Advocate to explain that
she is an agent of the Anderson Police Department and is obligated to pass
information to the investigating officer.
Release of Information: A release of information form shall be signed by a
victim if it would be helpful to discuss the needs of a client with a
therapist, doctor, or another agency outside the Anderson Police Department.
Otherwise, the name and information about clients of the Anderson Police
Department's Victim Advocacy program will be held in strictest confidence and
will not be disclosed to unauthorized persons.
OFFICE OF THE
PROSECUTING A TIORNEY OF MADISON COUNTY
Madison County Government Center
16 E. 9th Street. No. 5
ANDERSON. INDIANA 46016
Telephone (317) 641-9585
Fax (317) 641-9641
Rodney 1. Cummings, Prosecuting Attorney
PLEASE READ THE FOLLOWING INFORMATION
You must completdy rill out and Iign this form BEFORE your intenriew. After your
interview, this form will be evaluated and reviewed together with other avaHable
information BEFORE any criminal charges are rded.
NOTICE; False III/orming L C JS-I4-2-2(dW
. "A person who gives a false report of the commission ofa crime or gives false information in the
official investigation of the commission of a crihte, knowing the report or information to be false.
commits Fge ltiforming, a aan B MISdemeanOr. II
A Class B Misdemeanor is punishable by imprisonment for up to one hundred and eighty (180)
days and aJiM. of up to one thousand ($1,000.00) dollars.
COMPLAINT
Please print legibly, and fill out both sides of this form. If you need an extra sheet of paper for
your statement, please ask for one at the receptionist's desk.
YOURNAME__________________________ DATBOF BmTH._________
ADDRESS
PHONB:Home_____________________
VVo~~
ZIP_ _ _ __
_________________________
What type of incident are you rePorting?
When did this incident occur? Date:
--------------------n-un-e-:--------~Where did this incident occur?
If this is private property, what~~-------~~--~~------------------is the name and address of the owner?
Who is the person who committed the act which you are reporting?
NAME
DATE OF BIRTII
ADDRESS
-
ZW·-------------
PHONE: Home
Wo~
.--------------~------How do you know this person?--;;-;-:--:-__:-----:---:-:---=--=-_______________
_
Has this person ever made a complaint about you in this office?___________
When?
_______________________________________
Wb~
'/: ,J'
NAME (wt-Fint·Middk Initial)
SOCIAL SECURITY NUMBER
I
SPOUSE'S NAME
PHONE NO. (Home)
EMPLOYMENT
LOCAL HOME ADDRESS (Include ZIP Code)
PHONE NO. (Business)
-00 NOT WRITE BELOW THIS LlNE-
DATE
(
L_
DEPUTY or INTERN
I
(
(
STATE OF INDIANA
COUNTY OF MADISON
VS.
)
) SS:
)
IN THE MADISON _ _ _ _ COURT
DIVISION
199 TERM
CAUSE NO. 48
-----------------
AFFIDAVIT FOR RULE TO SHOW CAUSE
oath.--~----~~------------------alleges that
order previously entered herein as follows:
, being first duly sworn upon his/her
violated the protective
--~~--~---=~-----------
I affinm, under penalties of perjury, that the forgoing allegations are
true.
Signature
Printed Name
NOTICE TO APPEAR
.,............,.---:-__....,---:-:----,.-:,...--__:-----:-__:--___ i s he reb y 0 rd e red to appea r i n th e
Magistrate Court, Madison County Government Center, 4th Floor, on
,199 , to answer to the above allegations.
----~Y~o-u-a-r-e~he-r-e~b-y notified that if you are found in violation of the previously issued order of this Court, this Court may impose sanctions upon you to
and including incarceration for contempt of Court.
You are further notified that failure to appear at said hearing may result
in the issuance of a warrant for your arrest
IN WITNESS WHEREOF, I have hereunto set
my hand and Seal of said Court this
____ day of
199
t
Clerk, -------- Court of Madison
County
APPLICATION FOR BENEFITS
FROM VIOLENT CRIMES COMPENSATION FUND
State Form 23776 (A8 I 1-95))
• This state agency is requesting disclosure of Social Security numbers that are necessary to
accomplish the statutory purpose of this state agency according to IC 4-1-8 .
•• This info~ation is for statistical purposes only and will not effect the eligibility of the claimant.
o White
o Black
'Social Security number
o
Hispanic
0
American Indian
Other
Name
CLAIMANT INFORMATION
Name of claimant (if different (rom the victimllast, (irst, middle initial)
• Social Security number
Address of victim or claimant (number and street)
Work telephone number
City, state, ZIP code
Home telephone number
(
(
)
)
Claimant's relationship to victim
INJURIES TO VICTIM
What injuries did the victim sustain as a result of the victimization?
treatment
"ddress(number and street,
city, state,
code)
Name anending physician
Address (number and street, city, state. ZIP code)
give a description of the crime
police report was
Name
suspect (s)
Has suspect been arrested?
DYes
0
No
Were you willing to pursue prosecution?
~Yes
0
No
Jo". please explain:
number (if known)
agency
r"I,.. or\n~h,n
to suspect
Name of detective
Case number (If known)
INSURANCE
Were the injuries you sustained covered by any of the following?
o Medicare
o Medicaid
o Worker's Compensation
o County Trustee
Medical and / or car insurance amount $
Carrier(s)
Health Maintenance Organization carrier: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Social Security disability
$
Per Month
Social Security survivors benefit
$
Per Month
Life insurance death benefits
$
TOTAL
Worker's compensation benefits
$
Per Week
Employer disability benefits
$
Per Week / Month
Were you the beneficiary ?
DYes
D
No
street, city. state,
RELEASE
I do hereby release the State of Indiana and the Violent Crimes Compensation Division from any and all liability which might be connected with the
processing and payment of this claim. In the event the fund from which the award is paid, if the claim is allowed, is such that it is necessary to prorate
the payment of the claim, I do hereby release and discharge the State of Indiana and the Violent Crimes Compensation Division from any and all
liability beyond the amount actually paid to me from the fund.
SUBROGATIONS
The claimant hereby certifies that no release has been or will be given in settlement or for compromise with any third party who may be liable in damages
to the claimant; and the claimant, in consideration of any payment and/or award by the Violent Crime Compensation Division in accordance with IC
5-2-6.1-22, here subrogates the State of Indiana to the extent of any such payment and/or award to any right or cause of action occurring to the claimant
against any third person, and agrees to accept any such payment and/or award pursuant to the provisions of the statute. The claimant hereby authorizes
the State of Indiana to sue in his/her name, but at the cost of the State of Indiana, pledging full cooperation in such action, to execute and deliver all
papers and instruments, and do all things necessary to secure such right to a cause of action.
CONSENT TO PAY PROVIDERS
I do hereby consent and agree that if an award is made, money due and owing to any provider of medical services and due to ::Inv
or entity, including any attornev's fl'll'l<: "Unwcrt In ~ .. - .. - - - - .. - - ,
nthor " .. ~I;f;~"
------
Case ID #
DATE
VICTIM INCIDENT REPORT
Victim's Name
------------------------------------- Telephone
No.
--------------
Address:
Suspect:
---------------------------------------------------------------------------------------------------------------------------------
Relationship to Suspect:
Husband/Wife
--Ex-Husband/Wife
--Boyfriend/Girlfriend
==Ex-Boyfriend/Girlfriend
Parent/Child
-----Brother/Sister
Other
On the above date, the suspect above-named, touched me in a rude, insolent and angry
way as follows and caused injury to me:
vict~'s
vict~'s
initials
initials
Biting
--Cutting
--Dragging
--Grabbing
--Hitting
--Kicking
--Pinching
--Punching
--Pushing
==Spitting
Shooting
--Shoving
Slapping
----Smothering
--Stabbing
----Throwing
Threatening
- - S t r angling/ Choking
Other (describe)
----
Describe resulting injuries:
---------------------------------------------------ViC~~s
~ru
~
B
Was a weapon used? ___ yes
---no.
If yes, describe type of weapon.
_ _ _ _ ___
------------
At time of incident, was suspect under the influence of drugs or alcohol?
-----------
I hereby affirm under pains and penalties of perjury that the foregoing report is true
and accurate.
"VICTIM'S SIGNATURE
DATE
WITNESS-Investigating Officer
Name Printed:
------------------
;:~'_;~_"!';~~~:;;;;~
c;n:;!t Sf t tbJSl lI1t.lI*m_ cuxeu er CIA' Ila: ;Z:Htlfl. ",.', • : M i . riJlWrOi i Wi ,
•
COMMUNITY HOSPITAL· 1515 NORTH MADISON AVENUE· ANDERSON, INDIANA 46012· (317)- 642·8011
AUTHORIZATION FOR RELEASE OF INFORHATION
Patient's Address
Patient's Name
. Patient's. Telephone Number
Patient's Date of Birth
... :,...
;~'~~ The
undersigned het:ebY authorizes COMHUNITY HOSPITAL of ANDERSON. INDIANA to. release the
";f0110Ying portions of the'medica1 record oj the abov~-named patient:
.::' .•...
______Entire medica1' record for period of ___________________to_______________________________
_____The folloving
~pecifi~
for the period of
portions of the medical recora:
---------------------------------to--------------------------------------
Re1ease this information to:
Name of person or institution'
Address
This medical record informat·ion is needed for the folloving purposes : ____________________
..
(State general purpose or intended use of medical record)
I understand that I may- REVOKE this release at any time in vriting, but the request shall
remain valid until revoked or upon the expiration of sixty (60) days Yhichever occurs firsl
I also understa,nd that this release may include medical records of treatment for physical
and/or emotional illness, including treatment of ilcohol or drug abuse.
Date
\.1itness
**Signed
Relationship (if other than patient)
Telephone (if other than patient)
**If the patient is un~er 18 years,of age •. a parent must authorize.
**1£ th~ patient is incom~etcnt. a guardian must authorize.
"'-"""'1f the patient is deceased, the personal representative, if any. mus t authorize, if
none, sPOu6e,.if none, adult child.
,
Saint John's Health Care Corporation
Anderson, Indiana 46016
I hereby request and authorize Saint John's Health Care Corporation to furnish
.~.
any information In their medical records flies (or as specified below·) concerning
(Name of patient)
(Address of patient) I
I
f
for the purpose of ________________________~}----------------------------------------I understand that my records are protected under the Federal Confidentiality Regulations and can not be disclosed without my written consent unless otherwise provided for In the regulations.
It Is understood that this consent Is subject to revocation by me (us) at any time except to the extent that action
has been taken in reliance thereon. It Is also understood that this consent will expire 60 days from the day signed
unlessotherwlsespeclfled __________________________________________________________
~
In addition, I release Saint John', Health Care Corporation and It, personnel from any legal liability for releasing
the Information as I have reque.ted.
Hospital Number
Date of Birth
Date
Signed _____________________________
Wltness ___________________________
. Signed _____________________________
·Speclfy Information to be released:
Information released by _______________
768-12·1087
Date
AUTHORIZATION TO RELEASE MEDICAL INFORMATION
APPENDIX
B
Jane Doe
1000 East 4th Street
Anderson, Indiana 46012
Case #504980386
14 Apr 1998
Dear Jane,
I am a victim advocate with the Anderson Police
My job is to provide information, support and
guldance to persons who have recently had a bad experience
that has come to the attention of our department.
De~artment.
I received a copy of the police report describing a recent
problem that you had with John Doe.
If you would like to talk with me about how to deal with
abusive behavior, please call me at 648-6773.
I am
usually in my office Monday through Friday from 9:00 a.m.
to 5:30 p.m.
Many women find it necessary to leave their homes because
they do not feel safe there. Alternative's Shelter
provides a safe place for women victims of violence and
their children. Everything is free. Their number is
643-0200.
If you have any questions, or if you just want to talk
with someone about what happened, please feel free to
contact me.
Sincerely,
Lessa Parkison
Victim Advocate
Joe Smith
2111 West 8th Street
Anderson IN
46016
17 Mar 1998
Case #502981080
Dear Joe,
I am a victim advocate with the Anderson Police
My job is to provide information, support and
guldance to persons who have recently had a bad experience
that has corne to the attention of our department.
De~artment.
I received a copy of the police report describing a recent
problem that you had with Suzy Smith.
If you would like to talk with me about how to deal with
abusive behavior, please call me at 648-6773. I am
usually in my office Monday through Friday from 9:00 a.m.
to 5:30 p.m.
If you have questions or if I can be of assistance, please
contact me.
Sincerely,
Lessa Parkison
Anderson Police De~artment
Special Services Dlvision
POSITION DESCRIPTION
CITY OF ANDERSON, INDIANA
POSITION:
Victim Advocacy Coordinator
DEPARTMENT:
Police
JOB CATEGORY: PAT (Professional, Administrative, Tecbnological)
Incumbent serves as Victim Advocacy Coordinator for the Police Department, responsible for providing
physical and emotional assistance and support to crime victims.
DUTIES:
Supervises and directs program personnel, volunteers, and occasional college interns, including
recruiting and screening applicants, making hiring recommendations, providing training, making work
assigmnents, and evaluating performance.
Provides direct intervention for crime victims, including reviewing police reports, interviewing and
counseling clients, maintaining phone/mail contact, arranging emergency fmancial aid, providing
assistance and support to victims and their families throughout the judicial process, and conducting
follow-up visits to victims' homes, as needed. Organizes and conducts victim support groups.
Serves as client advocate, discussing, cooperating and negotiating with various individuals to ensure the
most appropriate action to serve client needs and obtain justice. Provides information to client regarding
procedures for ftling protective orders and complaints, and processing Victims of Violent Crime
Compensation Fund applications.
Serves as liaison between courts, law enforcement agencies, victims, and other advocate programs to
obtain and provide information regarding case status.
Transports clients to various appointments, such as meetings with criminal justice officials, legal
proceedings, and support group sessions, and accompanies clients as requested, such as during physical
examinations, court hearings, and interviews with detectives.
Researches and maintains files of available community resources designed to benefit victims, such as
services offered by shelter agencies. Meets with representatives of other advocate programs to
coordinate common efforts and information dissemination.
Maintains contact with police officers to facilitate program goals, including conducting ongoing training
in sensitivity to victims, and providing support and referrals to officers in need of counseling due to
personal or professional stress.
Provides a wide variety of community public relations/awareness services, including developing and
distributing brochures, recruiting and training community volunteers, making public speaking
presentations, and scheduling events to publicize Victims' Rights Week.
Maintains/updates statistical information regarding number of clients served and services provided, and
prepares a variety of monthly, quarterly and annual reports as required.
police\ victcoor
III. RESPONSmILITY:
-
Incumbent applies standard practices and procedures in making decisions on individual cases, following
precedents whenever possible. Work is reviewed periodically for conformance with department policies/
guidelines and soundness of judgement. Unusual cases may be discussed with supervisor prior to official
activity.
IV. PERSONAL RELATIONSHIPS:
Incumbent maintains frequent contact with co-workers, clients and their families, representatives of law
enforcement agencies, courts, and other advocate groups, and members of the public for purposes of
exchanging information, providing counseling and support, promoting education and understanding,
supervising personnel, and advocating appropriate action for clients.
Incumbent reports directly to Captain.
v. PHYSICAL EFFORT AND WORK ENVIRONMENT:
Incumbent performs duties in a variety of settings, including a stan~ office environment in a police
station, in victims' homes and at crime· scenes, involving exposure to distraught and/or potentially
violentlhostile individuals. Inc1unbent's duties involve sitting for long periods, sitting and walking at
will, close vision, hearing sounds/communication, and handling/grasping/fmgering objects. Incumbent
serves on 24-hour call for emergencies.
Written:
1988
Revised:
March 1998
police\ victcoor
POSITION DESCRIPTION
CITY OF ANDERSON, INDIANA
POSITION:
Victim Advocacy Assistant
DEPARTMENT:
Police Department/Police Substation
JOB CATEGORY: PAT (Professional, Administrative, Technological)
Incumbent serves as Victim Advocacy Assistant for the Police Department, responsible for
providing assistance and support to crime victims.
DUTIES:
Provides direct intervention for crime victims, including reviewing police reports, interviewing and
counseling clients, maintaining phone/mail contact, arranging emergency fmancial aid, providing
assistance and support to victims and their families throughout the judicial process, and conducting
follow-up visits to victims' homes as needed.
Serves as liaison between courts, law enforcement agencies, victims,. and other advocate programs
to obtain and provide information regarding case status.
Transports clients to various appointments, such as meetings with criminal justice officials, legal
proceedings, and support group sessions, and accompanies clients as requested, such as during
physical examinations, court hearings and interviews with detectives.
Provides information to clients regarding services offered by shelter agencies and procedures for
filing protective orders, filing complaints, and processing Victims of Violent Crime Compensation
Fund applications. Serves as client advocate, discussing, cooperating and negotiating with various
individuals to ensure the most appropriate action to serve client needs and obtain justice.
Works with Coordinator in providing a wide variety of community public relations/awareness
services, including distributing brochures, assisting in training community volunteers, assisting in
making public speaking presentations, and scheduling and assisting with events during Victims'
Rights Week.
Meets with representatives of other advocate programs to facilitate coordination of common efforts
and information dissemination.
Serves on various community committees and boards, attends monthly meetings, and maintains
interim contact.
Periodically attends professional seminars and training sessions, as needed or required.
Serves on 24-hour call, periodically responding to emergency situations as needed.
Performs related duties as assigned by supervisor.
police\ victasst
I. JOB REOUIREMENTS:
~
High school diploma or GED and specialized knowledge of counseling crime victims gained through
education and!or experience.
Ability to maintain confidentiality of legal records and reports, including client information/issues of
a sensitive nature.
Ability to read, interpret and apply a wide variety of state and federal guidelines and specific
regulations to particular situations and individuals.
Ability to tactfully and candidly interview clients and determine facts and specific circumstances in a
non-routine atmosphere, often involving distraught individuals.
Ability to effectively communicate orally and in writing with co-workers, clients and their families,
various government agencies, representatives of law enforcement agencies, courts, and other
advocate groups, and members of the public, including being sensitive to professional ethics,
gender, cultural diversities and disabilities.
Ability to serve on 24-hour call and respond swiftly, rationally and decisively to emergency
situations, occasionally involving potentially hostile/violent individuals.
Possession of a valid driver's license and demonstrated safe driving record.
~
ll. DIFFICULTY OF WORK:
Incumbent operates according to well-established departmental·guidelines and legal procedures,
providing assistance to individuals in potentially stressful situations with many variables or
considerations. Incumbent exercises independent judgement in making appropriate recommendations
and referrals.
m.
RESPONSmILITY:
Incumbent applies customary practices and procedures of the Victim Advocacy Program to
individual cases, with departures from guidelines and instructions discussed with supervisor.
Incumbent's work is primanly reviewed for accuracy, soundness of judgement, and compliance with
department policies and legal requirements.
IV. PERSONAL WORK RELATIONSHIPS:
Incumbent maintains frequent contact with co-workers, clients and their families, various
government agencies, representatives of law enforcement agencies, courts, and other advocate
groups, and members of the public for purposes of exchanging information, providing counseling
and support, and promoting education and understanding.
Incumbent reports directly to Victim Advocacy Coordinator.
police\ victasst
v.
PHYSICAL EFFORT AND WORK ENVIRONMENT:
'_ Incumbent performs duties in a variety of settings, including the Police Department, Police
"......., Substation, victims' homes, and crime scenes, where exposure to distraught and/or potentially
violent/hostile individuals may occur. Incumbent's duties involve sitting and walking at will, sitting
for long periods, hearing sounds/communication, close vision, and handling/grasping/fmgering
objects.
Incumbent serves on 24-hour call for emergencies.
Written:
July 1997
Revised:
December 1997
March 1998
,police'victasst
~1arch
24,
1998
To:
Capt.
John Burke
FR:
Lt.
RE:
Major Crime Scene Procedures
Mark Yeskie
Upon review of the recent homicide investigation, Case, 503980806,
procedural changes ",ill be implemented. I am reqllesting the following
proceollrps become effect,lve immediat.e.!;.-:
].
After discovey"y/location of crime scene is determined aJl personnel
\,- ill f' ,; i t t h p i mille di ate are a. A nOli t e r per i met e r ~'i 1 1 be ma i n to. i ned
b~- UII i I'orm personne I.
2. 1\ lin; ("orm sllpcrvjsor wilJ appoint_ a log entry ol"l"icpr. i Preferabl:-!Iw initial officer arriving at. scene). The Jog offic'er" ~'ill note
;,pTi,'A.] and depart.ure times of all personnel visiting scene. (To be
sta1.ioned at. outer perimet.Pl').
~. Al]
personnel arriving at scene will make contact with log
o r f i (' I' be for e ma kin g en try.
h. .-\ I J per son TI p I w ill. con t a C" t log 0 f fie e l' \.r hen 1 e a v i n g see n e .
c. A suppJ emen ta 1')' rpport ~'i 11 be regll ired f rom all personne 1
J ist.cd on crime scene log.
')
It is preferred that all personnel vacate the immediate area of
S('''JlP heron" videotaping and phQto~raphy "ork
js complet.ed !):-- L-th
l.pchnicians.
~. ExaminA.tion gJoves and booties will be W0rn hy lab and investigative
persollnel when entering crime scene.
5. Pc>rsolls arriving at crimp SCl"ne will be met at outer perimeter and
not le~d into crime scene unless approved by CID supervisor.
B. Dilly those persons with a need lo be at scene will be admitted.
6. After scene is cleared all investigative personnel will meet to
discuss additional action pending, investigative leads etc. before
leaving station.
7. Victi.m Advocat.e will contact log officer and will be briefed at
outer perimeter by on scene supervisor.
~. V.A. wjll C'ompJete case slIpplement on action taken.
b. V.A.. \,'1.11 contact CTD supervisor or leftd in\'(~stigator before
J'eleasing case informalion.
8. The Uniform silpervisor shall remain on scene until a CID supervisor
Arrivps.
(>
oJ
•
PTSD (Post Traumatic Stress Disorder)
Indicators:
1.
2.
3.
Fear of Death
Pre-existing psychopath
Disassociating
lout of 4 re-experience the event
a. intrusive thoughts
b. flashbacks, hallucinations, repetitive play in children
c. distressing dreams
d. intense psychological distress
3 out of 7 experience numbness/avoidance
a. thoughts, feelings associated
b. activities
c. amnesia
d. decreased interest in significant activities
e. estrangement/detachment
f. reduced affect
g. foreshortened future
2 out of 5 experience physical arousal
a. sleep disturbances
b. lack of concentration
c. startle reactions (hyper vigilance)
d. irritability
e. physiological
Long Term Crisis Reactions
1. Not all victims/survivors have
2. Many experience over long time periods
3. Usually trigger events set off (sensorial, criminal justice system,
anniversaries, media. etc)
DEATH NOTIFICATIONS
Survivor needs during death notification
1. Ventilation of emotions
2. Calm, reassuring authority
3. Restoration of control
4. Preparation and predication
-
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
Be absolutely certain of identity of deceased.
Get all medical information possible.
Go. Don't call.
Take uniform police officer with you.
Talk about your reactions on the way.
Present credentials; ask to come in.
Sit down; ask them to sit down; be sure you have nearest next of kin.
Inform simply and directly--with compassion.
Don't discount feelings, theirs or yours.
Join the survivors in their grief without being overwhelmed by it.
Answer all questions honestly.
Offer to make calls.
Talk to media only after discussion with the family.
Don't leave survivors alone.
Give written information.
If identification necessary, transport.
Next day, call and ask to visit again.
LET THE SURVIVORS KNOW YOU CARE.
Remember: In time, in perso~ in pairs, in simple language, with
compassIOn.
What not to say:
Discounting statements
I know how you feel.
Time heals all wounds.
You'll get over this.
You must go on with your life.
He didn't know what hit him.
You can always find someone worse off than yourself.
You must focus on your precious memories.
It's better to have loved and lost than never to have loved at all.
Disempowering Statements
You don't need to know that.
What you don't know won't hurt you.
God Cliches
It must have been hislher time.
Someday you'll understand why.
It was actually a blessing because _ __
God must have needed her more than you did.
God never gives us more than we can handle.
Unhealthy expectations
You must be strong for you wife/ children! parents.
You must get a hold of yourself.
What to say
I'm so sorry.
It's harder than most people think.
Most people who have gone through this react similarly to what you are
expenencmg.
If I were in your situation, I'd feel very
too.
I'll check back with you tomorrow, see how you're doing and if there's
anything more I can do for you.
SUGGESTIONS FOR CAREGIVERS
1.
Ask how survivors are doing and listen to their answers.
2.
Allow people to talk when they want to but don't attempt to force them.
3.
Ask about memories of the deceased.
4.
Accept all feelings and reactions as valid even when they are scary.
5.
Be prepared to hear "worse case" scenarios in a non-judgmental fashion.
6.
Don't be in a hurry when talking to survivors.
7.
Don't be afraid of silence.
8.
Don't betray confidentiality.
9.
Make arrangements to be with survivors but at their convenience.
10.
Explain clearly what will be expected of survivors; what they can expect of
you.
11.
Ask survivors how you can help and offer practical options.
12.
Be supportive but don't try to make the survivor feel "good".
13.
Attend memorial services and funerals when invited or when open to public.
14.
Offer to help with death notifications to others.
15.
Send written notes to show you care.
55
SPECIFIC SKILLS
A
Active listening-you can listen faster than someone talks, if you commit to
listen, then put all else aside and really listen.
B.
Mirroring-use to relax upset, uptight person. Match up-tight body language
and they will relax.
C.
Questions-person asking questions is in control
1. Open (lots of information)
2. Closed (specific information)
3. Who, what, when, where, but NOT why
D.
Parroting
1. choose one word
2. purpose-more information
E.
Reflecting-Victim Advocate guesses how the victim is feeling. The victim
will correct.
1. diffuses
2. get emotions out
.-....
.
F.
Paraphrasing
1. clarifies
2. forces you to listen
3. lets them know you're listening
4. lets them hear what they said
G.
Silence
WHAT lffiLPS
A.
water-cool not iced
B.
exerCise
C.
talking
D.
tears
E.
accurate infonnation
F.
choices (small not big)--it helps put people back in control
G.
the colors you wear--don't wear bright colors; wear blue or green
H.
group debriefmgs
I.
massage
J.
anchoring
K.
expand the event
APPENDIX
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Cotto9eview Children's Center. Inc.,
P.O. Bo-t 902
~nderson, Indiana
460 \ :'-0902
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I would like to become a member of Cotto9eview Children's Center. Inc..
Enclosed is my annual membership fee:
$25,00 Organization Membership
$15,00 Individual! Family Membership
I want to make a contribution in the amount of $ _ _ _ _ __
I want to contribute by serving as a volunteer.
I would like to schedule a speaker to speak to my organization.
I want to work on a committee: Fund-raising, Property, Program or Finance.
Name! Organization _________________________________
Address _____________________________________________________________ _
......"
Phone (_ __
I want to be a supporting member of Cottageview Children's Center but cannot afford the membership fee of$15.00 at the present time.
C;>tto9e11iew Children's Center, Inc.
is an Equal Opportunity Employer
is a
not-for-profit agency. Our mission is to
provide comprehensive services to child
victims of abuse and neglect. Cott"9{'l/iew
coordinates investigation and intervention
services by bringing together professionals
in a multidisciplinary team to create a childfocused approach to child abuse cases. The
goal is to ensure that children are not further
revictimized by the very system designed to
protect them,
Wr\Y DO WE NEED
COTTf\GEVIEW
Cr\ILDREN'S CENTER~
Cuttn9CViC'N Childrcn's Ccnter, Inc..
The Center Will Provide:
t} Comprehensive interviews/investigation
Wr\f\ TWILL Tr\E
Cr\ILDREN'S CENTER
A
t} Case reviews and tracking
BE~
facility . . . that provides a non-
threatening and child-oriented environment,
where I.:hild vidims are
made as
comfortable as possible ~ ''i
during the inve.stigative
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process, redUCing the >f lS..Vl. -~r
trauma of the abuse.
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~ Prevention Programs
A program ... that brings the system to the
I.:hild rather than shuffling the child from
agency to agency. The needs of the child and
the family are always the first priOlity of
emphasizes
collaboration hnd cooperation among
professionals. Child protective services
specialist, law cnforcement officers, medical
and mental health professionals, and the
Prosecutor's office all working together as a
team.
Children Support Groups
Adolescent Support Groups
Non-offending Family Support Groups
-A Court School
establishment of
c"tt''',)cl/icw
is truly a
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community effort. The ongoing support of our
community will insure the continued
services of this resourl.:e for child abuse
victims and their fam ilies.
t} Becom ing a member of the agency
~ Becom ing a volunteer
UAppropriate referrals
, . . that
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Mental Health Treatment
Medical Evalutation/Exam ination
c"tt"9 Niew .
r\OW Cf\N Tr\E
COMMUNITY r\ELP~
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An approach
Children in our community are being beaten,
molested, neglected and even killed at record
rates. Indiana rt:pol1s that in fiscal year
1996-97,23,160 children were found to have
been abused or neglected. Madison County
has a 60% higher rate of child abuse than
other counties in the state.
i::r Community Education
~
Promoting awareness by scheduling a
staff person to speak Oil the issues of
ch iId abuse and neglcl.:t to your church,
social service organization or club
1>: Helping raise funds through fund-raising
projects
~ Comprehensive Professional Training
"i); Educating and advocating fl)r legislation
at the state and nationallcvel
Cttcge,'lc>, is parliali (~
Criminal Justice Institlll i
) through the Indiana
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"COURT SCHOOL"
FACILITATORS:
Length:
Place:
Ann Taylor, Madison County Court House, Anderson
Amy Pointer, Alexandria City Court
Judge "Mia" Roby, Elwood City Court
_
1 (1 % hour session)
Madison County Government Center, Alexandria City Court,
Elwood City Court
What is Court School?
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Court School is a service offered by Cottageview Children's Center, Inc. It helps children and parents
understand the court process and enables children to understand what is expected of them if they should testify.
Several children with upcoming court cases are brought together to participate. Court School explains the trial
process on a child's level and does not require participants to discuss individual cases.
How Does It Work?
Your child will receive an invitation addressed to him or her about two weeks before Court School. Court School
lasts about 1 ~ hours. The Court School session is scheduled prior to the trial date. However, because trials
are often reset, the child may attend Court School long before the actual trial.
Does My Child Have to Go?
No one has to go, but we encourage everyone to attend. Every part of testifying in court is new to most people.
Parents are welcome. VVhat you and your child learn in Court Schoot will make the courtroom process easier for
everyone.
Why Should My Child Go?
Children's ideas about court may be based only on what they've seen on television. At. Court School, your child
will learn about where the judge will sit the court reporter, attorneys and other courtroom personnel. They will
leam what to expect the day they testify. What your child learns in Court School helps make the trial process
easier to understand and reduces the anxiety about testifying.
Is Court School Hard?
No, there are no tests or papers to write. Court School is designed to be fun and relaxed.
the kids ad out the roles of the courtroom personnel.
How Do I Get More Information?
-
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If you want more information, please call: (765) t)44.74n
Through role place,
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COTTAGEVIEW CHILDREN'S CENTER, INC.
541 No. Broadway
Phone 644-7477
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ADOLESCENT SEXUAL ASSAULT SUPPORT GROUP ·1
Facilitator: Gail L. Smith, MSW, ACSW, LCSW, LMFT
Cost:·
Fre~
Length: 6-8 weeks
Place: 541 No. Broadway
"NEW BEGINNINGS"
Session #1
Introduction to Group.
Ground rules. Individual and group goals. Safety plan.
Session #2
Sexual Assault Myths, facts, and feelings.
Session #3
Incest· Characteristics of Family Sexual Abuse. Feelings incest survivors.
Session #4
Victimization. Page in My Journal. What Happened to Me.
Session #5
Sharing.· Letter writing to perpetrator
Session #6
Self-esteem
Safety plan.
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corrAGEVIEW CHILREN'S CENTER, INC.
541 No. Broadway
Ph: 644-7477
Facilitator: Karen Helsel, SA (Psychology), Pastoral Counselor
Length:
Cost:
Free
Place:
541 Broadway
8 weeks
CHILDREN OF DIVORCE
"Healing Hearts"
Ages 6-12 "I Am Important, I Counr'Mondays, 6 - 7 p.m.
Ages 13-18 "I Am Loved, I Am Who I Am" Tuesdays, 7 - 8 p.m.
Session I
Introduction and Trust Building Activities
"I Am Important, I Count'" 'Who Am I?"
Session II
Myths and Facts:
Magical Thinking
Session III
Survival Skills to Live in Two Worlds
Session IV
To Trust or Not to Trust - "Can I believe you?"
Session V
'What about my feelings?"
Session VI
Grieving losses
Session VII
Working it out .. Age appropriate coping skills
Session VIII
Affirmations of Hope... going on from here
IIlf Only•..
Of
Note: The sessions will be similar in content for both groups, but with age
appropriate activities and presentations.
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"HELPING CHILDREN COPE wrm DIVORCE"
Cost:
FaciIitator:
$200 a session
(SchoIarships available)
Gail L. JOY Smi~ MSW,ACSW,LCSW,LMFT
Length: 8 weeks Brown Bag Lunch
PJace: Cottageview Oilldren's Center
l\fONDAY LUNCH
541 Broadway, Anderson,. Indiana
CALL (765) 644-7477 TO REGlSfER
OIn.DREN'S CONCERNS DURING 1HE BREAK UP
Session# 1
YOU CAN HELP YOUR a-IlLDREN Sl1C'CfSSFULLY ADJUST TO DIVORCE
Session # 2
DIVORCE CAUSES SEPARATION ANXIETIFS: ·IF DAD LEfT, WON'T MOM GO
AWAYTCXYr'
Session # 3
<liILDREN WANT TO REUNITE 1HEIR PARENTS: "IF rM REALLY GOOD, MAYBE
MOM AND DAD WILL GET BACK l'CXJElHER AGAIN."
Session # 4
OiILDREN FEEL RESPONSIBLE FOR TIiE DIVORCE: "MAYBE IF I HAD BEEN GOOD,
MOM AND DAD WOULDN'T HAVE GOTIEN A DIVORCE."
OIn.D-REA1UNG AFfER DIVORCE
Session # 5
MEO-lANICS OF CO-PARENTING. GROUND RULES FOR COMMUNICATING AS
CO-PARENTS. LOYALlY CONFUCIS.
Session # 6
PAREN1lFlCATION: 1URNING OllLDREN INTO ADULlS. TI-IREE TYPES OF PARENTIFICATION.
1HE ADVERSE CONSEQUENCES OF PARENTIFYING OUR a-IlLDREN. ASSI3SING
PARENTIFICATION IN YOUR FAMILY.
Session # 7
a-IlLD-REARING PRACllCES. 1HREE APPROAa-u:s TO DISClPUNE..
DISClPLINE AFTER DIVORCE. CliILD-REARING GUIDE UNES.
Session # 8
STEP-FAMILIES: FORMING NEW FAMlL Y RELATIONSHIPS.
·.
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PARENTING CLASSES
IN
PENDLElON
ALEXANDRIA
ELWOOD
Cost: $8.00 per session
FAClLITAlOR:
TIME:
DAVIDKAVICH,~
Length: 8 weeks
EVenings 7:00-8:30 p.m.
Call the office for the meeting places in your area..
Send in Registration to:
COITAGEVIEW CHILDREN'S CENfER,. INC
P.O. BOX 902
ANDERSON, IN 46015-0902
Name________________________________________________
Address,______________________________ Phone._ _ _ _ _ _ __
City_ _ _ _ _ _ _ _ _ _ _State._____________.Zip_______
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CRIME
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HOW DOES TRIAD WORK? \
(' 1. Ed~cate:. Sponsor crim~; . .
and victim/witness
; . prevention
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programs for older persons.
S.A.L.T. == Seniors And Law
enforcement Together
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Triad is the agreement of the law .
.. enforcelnent agencies''inla' county
: .(Sheriff s office, p()lice ,depart;.
· .ments; etc~) and older' of retired
· 'personsin the commUnity to work
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The S.A.L.T. Council is the advisory
group which carries out Triad
activities. Members of S.A.L.T.
groups include:
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Police chiefs or designated officer
Sheriff or designee
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RSVP
AARP
Agency on Aging
Mature/retired leaders
Home extension service
Emergency response representative
Others interested in the welfare of
seniors
4. Communic~~te: Provide).: forum
:; " for law'enforcement arid the .
. community to shru:e need~; an~
concerns-and develop solutIons.
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3. Emphasize:
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reduce fear and provide moral
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Triad 'is a joint approach to crime
issues which affect older citizensand the enhanced delivery of law
enforcement services to. these
mature persons.
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·T'rlad·is the conceptot.~ooperation
'to'reduce the crimiriat victimization
'ofthe elderly.
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carries out activities through the
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crime prevention education, publicity,
.special events, reassurance strategies~
elder abuse prevention, etc.
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What is a Community Crisis?
Whole conummities,like individuals, may suffer trauma in
the aftennath of disasters or especially gruesome crimes.
The community may suffer from an effect :;imilar to
paralysis. While almost everyone is in shock, mdividual
reactions may vary. Individual s may experien:e a wide
variety of emotions, such as anger, fear, sadness,
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helplessness, and euphoria.
Madison
County Crisis
Response
How Can a Response Team Help?
The experienced care givers in the community, "ho would
normally be called upon to help, may also be involved in
the crisis as members of the community. For this reason,
it often helps to have outsiders come for a shol1period of
time to offer information and suggestions 011 how to
prepare to respond to the community's distress.,
TealTI
Who are the MCCRT Members
and What Do They Do?
Madison County Crisis Response Team men'tbers are
professionals, who have completed a forty hOUl training
program provided by the National Organization f >r Victim
I\ssistance. Members include victim advoca~( s, clergy,
,aw enforcement persoJU1e1, and other specialists .vho have
I'olunteered to serve,
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fhe MCCRT will perform these specific tas(s in the
;ommunity:
'
Help local decision makers to identify the ~oups at
risk of experiencing trauma;
Provide training to the community care gi vers who
must
reach out to those groups at risk; and
Lead one or more group crisis intervention Sl :ssions to
demonstrate how these pri\'ate meetings car help
\'ictims begin to talk about their reactions to the
traumatic event and to cope.
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Madison County Crisis
Response Team
MISSION STATEMENT
he mission of the Madison County Crisis Resp('nse Team
to provide crisis intervention services to Madison
ounty residents who have experienced or beer impacted
)' trauma sufficient to overwhelm their USl al coping
Ipacities. Excluded from this target group are ( mergency
:nice persolUlel who receive similar assistanc! from the
CCIST Team with whom we will maintain a ~ upportive
ld collaborative relationship. Additionally. it is the
ission of the Madison County Crisis Respons ! Team to
spond to disasters in other locales when requ( sted to do
) by NO VA (National Organization fo I' Victim
ssistnnce) and when it is possible to do so.
Referral Procedures
The Madison County Crisis Response Team provides
services, upon request, to any community within' Madison
County where a crisis-like event has taken place.
Examples of such trauma inducing events would be:
natural or manmade disasters such as floods or violent
storms, plane crashes or fires; criminal incidents of a
nature that the entire community is thrust into grief; or
incidents involving children, such as serious automobile
accidents, cluster suicides, or mUltiple deaths from any
means.
A Madison County Crisis Response Team is dispatched
24-hours through the American Red Cross of Madison
County.
Services and Cost
MCCRT will send a team to any community in Madison
County upon official request. This official request or
imitation should come from someone with authority at the
site of the community crisis. Generally,.team members can
respond within four (4) hours. The response team will
require assistance in locating a private area in a public
building of adequate size to provide training to local
community members, and to hold group crisis intervention
sessions for victims and care-providers to the crisis event.
There is no fee for MCCRT sen'ices, however, local
community organizations may provide support. If local
businesses are able to provide accommodations or meals,
for example, this helps to reduce team members' out of
pocket expenses.
Auxiliary Serv·ices
When appropriate, the Madison County Crisis Response
Team will request a National Crisis Response Team from
the National Organization for Victim Assistance when the
scope of the community crisis is extensive, and when
national media may be likely to respond to the Madison
County community. After the initial request is made to
NOVA, MCCRT will serve as an intermediary between
the local individual responsible for inviting the NOVA
team, and the NOVA staff arranging the national team
response.
The Madison County Crisis Response Team will
coordinate
with existing Critical Incident Stress
Management Teams, the Red Cross, or any other
organizations responding to the community to insure
comprehensive community wide services and to avoid
duplication of services.
Also, in those situations where individuals have particular
trauma induced by the community crisis, MCCRT will
request victim advocates from nearby communities to
assist in pro\'iding crisis inten'ention counseling on an
individual basis.
••••••••••••••••••••••••••••••
TO BRING A CRISIS RESPONSE TEAM TO
YOUR COMMUNITY CALL
AMERICAN RED CROSS
OF MADISON COUNTY
765/643-6621
(24 HOURS)
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Survivors
of
Homicide
FOR MORE
INFORMATIONN
Support
Group
We invite you to attend our
meetings. For more infonnation, you may leave a message
on our voice mail service at:
317-646-5848 ext. 284
317 -646-9301 ext. 4868
317-641-9673
or you may write to us at:
Madison Co. Victim Advocacy
Survivors of Homicide
16 E. 9th St., Box 5
You are not alone! By sharing your
loss and oun, we move from being the
victim to becoming a survivor. Our
lives have been shattered by the
ultimate Invaslon ... MURDER. By not
building a wan around ourselves and
being involved with people of similar
tragedies, we help to begin the heaUng
process.
Anderson, IN 46016
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----------~o~---------SURVIVORS OF HOMICIDE
Survivors of Homicide Support Group is a selfhelp support group organized to help families and
through grief before, it is difficuh to feel that they truly
friends of murder victims. Sharing the experiences
understand your pain. Our circumstances that brought us
of our loss, and allowing others to do the same,
together may be different, but our despair is the same.
Although others who care for you may have been
To compound your pain, you may be thrust into
the criminal justice system and forced to accept
system where the criminal seems to have all the
rights. You may have the agony of the murderer
not being apprehended. If the murderer takes
each month on the fourth floor of the Madison
• Anger toward God.
* See your loved one in a crowd.
County Courthouse, in hearing room two (2).
We begin with introductions and each member
* Feel people are avoiding you.
telling the story of their loss. We divide our
• Why has this happened to us?
meetings during the year between topics,
• Why Can't our families understand?
special guest speakers and nights that remain
open to any discussion. We are open about
• Can't relate to others.
* Am I being punished for previous mistakes?
every aspect of our loss.
• Suicidal thoughts.
• Repeat details of death.
No one is afraid to express their feelings and no one is
it takes a few months or several years, it takes as long as
you need it to take.
• Need to visit cemetery.
• Can't visit cemetery.
replace individual therapy or counseling if that is
--
--(
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• Loss of energy.
* Cry at unexpected times.
* Feel cheated.
there to judge. Grief is an individual thing, and whether
Very specific, self-help support groups do not
MEETINGS
I
Whether you are a spouse, parent, child, sibling
or friend of a murder victim, your suffering is
shared by others who understand your loss.
feelings that we have experienced:
• Can't concentrate on work.
their own life too, you're expected to accept this
as justice.
victim we offer a list of a few of the
Our meetings are held the first Thursday of
the intrusions of the police and the media. If the
murderer is arrested, you will have to face a
As family and friends of a murder
• Can't make decisions.
helps rebuild our shattered lives.
AFTERMATH
When someone you love is murdered, the normal
grief experience is intensified. Knowing that
someone intentionally took the life of your loved
one magnifies and extends the griefprocess.
------~<>~-----­
SOME NORMAL FEELINGS
needed. Many of us go to both.
• Feel guihy when I have a good time.
* This is a nightmare.
* Tolerance with others is lower.
• Past hopes and goals disappeared.
We have no religious creed or affiliation. There
are no dues charged, you have paid enough. All of
• It's been over a year - why don't I feel
better?
our funding is dontated.
-------<)
• May feel like you're having a nervous
breakdown, you're probably not.
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Health Care &
Domestic Violence
•
families to
ano/her,
Projeft:
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WI.! IIIltst end the deadly
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Project: HAVEN
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responses to
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,lddr.:ss, 19<)6)
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falnily violence.
h(//le!' l1'!Jmt!fI, 70% a/so
children,
OJ.lf!U/II(,
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HAVEN
llealthcare &
Advoclltes
Violence Elil1J;nation
Network
Ihl.!
ohllse Ihe sillg/e /IIost
idelllifiuhl" risk jilc/or .lor prediclillg
child (/hll.ll',
(Hospitals, 1992)
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of \\lilllt'll IIIJ() were physically
(Jbllsed by Iheir parI lias did 1101 discliss
the illCicil'lIl,1 Il'ilh Iheir physicial/S: 57%
did 1101 ,/i.ltl/I,I Ihe' illcidellls wilh
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Project FUllded By:
WI)'Olle,
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Shelle!',1 (}lIir !'I.!och o//c 0111 of II.! II
I\'(J/I/('II )I'ho IIccd IIiL'il' ,I ('r\'ices,
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j'io/L'l1ce AguillSI
fl1l.:g/'''/lIlg Jleallh &
l.e,!.!,tI/ COl/Il/llll1ities, 1993)
II',JII/L'11
Cummullity /Jo,\pital
of Allderson & Madison COllll(r
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the S. T.O.P. Violence Agaillst
Womell Act through the
III dian a Criminal Justice Illstitlite
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A Program of
Alternatives Incorporated
of Madison County
P.O. Box 1302, Anderson, IN 46015
(765) 643-021 S
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Services Offered
In l'vlay 1995, Alternatives Incorporated oj'
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Trainingfor Health Care Professionals
and Communit)' Ho.\pital o{
2.
Public Awareness Materials
Madison
('01I11(V
1(ey Identifiers of
Domestic Violence
Bui/dil1~
Alldersoll & ,\1udisol1 COllntv launched the
3. COlJlmunily Response
jil'sl
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Trainingf{)!' ,\'ocia/ Sen'ice Proji'ssiol1([ls
The collahor-
6.
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DO/l/cstic Violence Protocols
domestic
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('risis Re.\/JOl1se Team Derelo/)/I1('11I
catal),st for
9.
()I1-.)ite Advocacy
Indiw]([
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pl'cI'eJ71ion
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pr(l\'ider's
response
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FI1j(m'ell1ent 7,'uil1illK
s/I'eIlKtheniIlK the comn1unitY-lI'ide domestic
\'iolence initiuth'c.
Domestic Abuse
American Medical Assoc.,
Women' 5 Health Overview, 1995
Frequcnt ER Visits
•
Wit hdr(/\ \'II. Ik/JU'.lscc/ Po/icllt
•
Multiple Silicide
•
IncOllsistcl1t Physicol Filldillgs
•
()rcrprolL'c/iI'C' ,\ignijicol7/ ()ther
•
Injllries to I/cu(/ (\' ,<..,'(',n/(/I Organs
•
Multiple Injllries ill /'([riolls ,':tuKes of
Healil1R
•
Alcohol or DruR Ahllse
•
One Car Accident
!1IfclIl/JIS
• Delayed Carc
• Inappropriate Beharior
A pattern of coercive and controlling
Physicians and
other health care
professionals see the
consequences offamily
violence every day and are
in a pivotal position to
help their patients who
have been abused.
•
(uncontrollabl c cryi 11K/laugh ing,
silent, sullen)
behavior (known as battering) that occurs
in all adult intimale relationship. Abuse
Battered Woman's
Testilnony
takes many forms and has un enormous
impact on victims physical and mental
"I was terrified that someone would
health.
: ask me ho\l' I got Illy il1jurics.
! iust
as terrified thut
110
1 was
onc would ask
: me and I \\'Ouid ha\'e to return home
without talkil1K to anyolle aholll what
Fees vary according fa
was happenil1R to
services rendered
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VICTIM
ASSISTANCE
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Office Advocate:
Anderson Police
Department
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VICTIM ADVOCACY PROGRAM
700 Meridian Street
Anderson, IN.:(
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Who is a victim?
Services Provided:
• Referrals
A victim is any person who has directly
suffered an emotional, physical, or personal
loss as a result of a criminal act.
• Crisis Intervention
Response to crisis situations involving
violent attack, death, sexual assault,
and/or emotional trauma twenty-four (24)
hours per day.
Referrals to other criminal justice a
social service agencies.
• Assistance
Provide transportation to the police'
department, shelter, court hearings.
• Emotional Support
Anderson Police Department
Victim Advocacy Program
Understanding of trauma reactions
experienced by victims and guidance
toward emotional stability and recovery.
• Criminal Justice Information
Victimization by crime can be a difficult time
for most people. The Anderson Police
Department's victim advocates assist crime
victims in recovering from the physical,
emotional and financial impact of the crime.
Assistance is also provided to victims during
their involvement with the criminal justice
system by making the system more
accessible, easier to understand, and more
responsive to their needs.
Information about the criminal justice
system, laws, policies and procedures.
• Case Status Information
Information regarding the progress of
his/her case through investigation.
Accompany victims during physical
at hospitals, formal statements at
police department, protective order
, hearings in court.
Assist victims in filling out State
Crime Compensation forms.
• Public Speaking and Communi
Education
The Victim Advocacy Coordinator is "
. available to present educational pro
free of charge. Presentations can be
scheduled through the Victim Ad
Office.
• Advocacy
~
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)
Efforts are focused on ensuring the most
appropriate action by the police
department and cooperating with other
criminal justice agencies to obtain justice.
Lessa Parkison, Coordinator
,Office: (765) 648-6773
Fax:
(765) 648-6779
Pager: 640-6430
t'"
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-
INDEX
INDEX
,-
12
ACCIST
51
Accompaniment
49
Advocacy
7
Annual Report
35
APD Case Management
39
Appellate Courts
9
Assigning Cases
40
Bail
15
Brochure
9
Card File
36,37
Case Number
42
Case Status
40
Charge
12
Child Trauma Team
Citizen's Academy
52
39
Civil--definition
12
Community Services Council
33,40
Complaint(Appendix A)
15
Confidentiality
12
CottageView
40
Count
38
Courts
39
Criminal--definition
19
Crisis
18
Crisis Intervention
Death Notifications (Appendix B)
40
Defendant
47
DetectiveNictim Interview
14,48
Directory of Social Services
Discounting Statements (Appendix B)
Disempowering Statements (Appendix B)
Emotional Reactions
28
Employees
8
40
Felony
9
Files
11
GAP
God Cliches (Appendix 8)
Grants, Administering
6
Grants, Writing
3
Guilty Plea
41
44-46
Home Visits
13
ICADV
4
Icn Grant
13
INCASA
Indiana Criminal Justice
4
Institute Grant
Indiana Department
38
of Corrections
8
Interns
32
Invasion of Privacy
8
INVOLVE
13
IVAN
38
Jail
46
Letters (Appendix B)
Liaison
16
Long Term Crisis Reaction (Appendix B)
13
MADD
6
Madison County Foundation
Major Crime Scene
Procedures(Appendix B) 20-21
Mayor's Commission
on Domestic Violence
11,52
Medical Personnel
52
Medical Release
Form(Appendix A)
37
Misdemeanor
41
No Drop Policy
43
NOVA
13
Officer Training
13
Parole Department
38
Perpetrator
41
Phone Calls
47
Physical Reactions
28
Post Traumatic Stress Disorder
(Appendix B)
Predict
27
Prepare
27
Probable Cause
41
Probation Department
38
Project Haven
II
-
38
Prosecutor's Oflice
Protective Orders(Appendix A)
31-33
52
Public Speaking
7
Quarterly Reports
7
Quarter Periods
Redliner(Appendix A)
36
48
Referrals
Rule to Show
Cause(Appendix A)
34
Safety
23
Sexual Assault Coalition
11
Shall Arrest Policy
42
Sharing Own Story
30
Small Claims(Appendix A)
34
Standard Operating Procedures
14
Statistics
17
Subpoena
41
Suggestions for Caregivers (Appendix B)
Summons
41
Supervision of Children
50
Supplemental
Report(Appendix A)
37
12
Survivors of Homicide
42
Suspect
TRIAD
11
50
Transportation
Unhealthy Expectations (Appendix B)
26
Validate
25
Ventilate
Victim Advocate--other
39
Victim Compensation
Fund(Appendix A)
49
Victim Incident
Report(Appendix A)
37
Victim's Rights Week
13,53
VictimIWitness
Asssistance Analysis
14
Volunteers
8
Warrants
18
-
RESOURCES
RESOURCES
Anderson Police Department Advocacy Program
Anderson Police Department: Detective Division
Anderson Police Department: General Orders
Anderson Police Department
CottageView Children's Center
Counseling and Advocacy Workshop, Thursday, March 2, 1995, presented by Viki Sharp
Indiana Attorney General Victim Advocacy and Assistance Program
Indiana Criminal Justice Institute Violent Crime Compensation Fund
Indiana Criminal Justice Institute Crime Victims Assistance Grant Program Application Kit
Madison County Crisis Response Team
Madison County Prosecutor's Office
Madison County Victim Advocacy Program
Madison County Court Administrator's Office
Project: HAYEN
Survivors of Homicide
TRIAD