SOP 208.06-att-12: PREA Victim Advocate Request Form

Division:
Executive
Effective Date:
June 23, 2022
Topic Area:
Policy-Compliance Unit
PowerDMS:
View on PowerDMS
Length:
200 words

Summary

This form is used to document whether an inmate who is a victim of sexual abuse or assault requests the services of a victim advocate. The form informs inmates of their right to have a victim advocate (from a rape crisis center or qualified community staff) accompany and support them during forensic medical examinations and investigatory interviews. The inmate must indicate their choice and acknowledge understanding that the advocate provides emotional support and crisis intervention, not legal representation or investigation.

Key Topics

  • PREA
  • Prison Rape Elimination Act
  • victim advocate
  • sexual assault
  • sexual abuse
  • rape crisis center
  • forensic medical examination
  • investigatory interview
  • emotional support
  • crisis intervention
  • inmate rights

Full Text

SOP 208.06
Attachment 12
Revised: 06/23/22

# GEORGIA DEPARTMENT OF CORRECTIONS PREA Victim Advocate Request Form

In accordance with the Prison Rape Elimination Act (PREA) 28 C.F.R. Part 115.21 (d) “The
agency shall attempt to make available to the victim a victim advocate from a rape crisis center. If
a rape crisis center is not available to provide victim advocate services, the agency shall make
available to provide these services a qualified staff member from a community-based organization,
or a qualified agency staff member.”

The Function of the Victim Advocate as outlined in 115.21 (e) is “As requested by the victim, the
victim advocate, qualified agency staff member, or qualified community-based organization staff
member shall accompany and support the victim through the forensic medical examination process
and investigatory interviews and shall provide emotional support, crisis intervention, information,
and referrals.”

Select one:

I _DO_ request the services of a Victim Advocate

I _DO NOT_ request the services of a Victim Advocate

This is to acknowledge I understand I have the right to be a Victim Advocate. I further understand
their role is supportive in nature and not investigatory or representative of legal counsel.

______________________________ _____________________

Offender Name GDC #

______________________________ _____________________

Signature Date

Record Retention: Retain permanently in the investigative file.

Attachments (19)

  1. Sexual Abuse_Sexual Harassment Prison Rape Elimination Act Education Acknowledgement Statement (281 words)
  2. PREA Sexual Victim_Sexual Aggressor Classification Screening Instrument (64 words)
  3. PREA Disposition Offender Notification Form (27 words)
  4. Sexual Allegation Response Checklist (269 words)
  5. Procedure for SANE Evaluation/Forensic Collection (1,673 words)
  6. PREA Investigative Summary (433 words)
  7. PREA Local Procedure Directive and Coordinated Response Plan (735 words)
  8. Retaliation Monitoring Checklist (180 words)
  9. Sexual Abuse Incident Review Checklist (312 words)
  10. PREA Initial Notification Form (231 words)
  11. PREA Staffing Plan Template (1,078 words)
  12. PREA Victim Advocate Request Form (200 words)
  13. Contractor/Volunteer Verification Form – Sexual Abuse/Sexual Harassment (PREA) (312 words)
  14. PREA Counseling Referral Form (141 words)
  15. Investigative File Summary Checklist (222 words)
  16. Investigative File Detail Checklist (580 words)
  17. Prison Rape Elimination Act (PREA) Offender Brochure (English) (341 words)
  18. PREA Offender Brochure (Spanish) (439 words)
  19. Staff Guide on the Prevention and Reporting of Sexual Misconduct with Offenders (1,289 words)
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