SOP_NUMBER: 208.06-att-12
TITLE: PREA Victim Advocate Request Form
DIVISION: Executive
TOPIC_AREA: Policy-Compliance Unit
EFFECTIVE_DATE: 2022-06-23
WORD_COUNT: 200
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/936659
URL: https://gps.press/sop-data/208.06-att-12/

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

ATTACHMENTS:
  1. Sexual Abuse_Sexual Harassment Prison Rape Elimination Act Education Acknowledgement Statement
     URL: https://gps.press/sop-data/208.06-att-1/
  2. PREA Sexual Victim_Sexual Aggressor Classification Screening Instrument
     URL: https://gps.press/sop-data/208.06-att-2/
  3. PREA Disposition Offender Notification Form
     URL: https://gps.press/sop-data/208.06-att-3/
  4. Sexual Allegation Response Checklist
     URL: https://gps.press/sop-data/208.06-att-4/
  5. Procedure for SANE Evaluation/Forensic Collection
     URL: https://gps.press/sop-data/208.06-att-5/
  6. PREA Investigative Summary
     URL: https://gps.press/sop-data/208.06-att-6/
  7. PREA Local Procedure Directive and Coordinated Response Plan
     URL: https://gps.press/sop-data/208.06-att-7/
  8. Retaliation Monitoring Checklist
     URL: https://gps.press/sop-data/208.06-att-8/
  9. Sexual Abuse Incident Review Checklist
     URL: https://gps.press/sop-data/208.06-att-9/
  10. PREA Initial Notification Form
     URL: https://gps.press/sop-data/208.06-att-10/
  11. PREA Staffing Plan Template
     URL: https://gps.press/sop-data/208.06-att-11/
  12. PREA Victim Advocate Request Form
     URL: https://gps.press/sop-data/208.06-att-12/
  13. Contractor/Volunteer Verification Form – Sexual Abuse/Sexual Harassment (PREA)
     URL: https://gps.press/sop-data/208.06-att-13/
  14. PREA Counseling Referral Form
     URL: https://gps.press/sop-data/208.06-att-14/
  15. Investigative File Summary Checklist
     URL: https://gps.press/sop-data/208.06-att-15/
  16. Investigative File Detail Checklist
     URL: https://gps.press/sop-data/208.06-att-16/
  17. Prison Rape Elimination Act (PREA) Offender Brochure (English)
     URL: https://gps.press/sop-data/208.06-att-17/
  18. PREA Offender Brochure (Spanish)
     URL: https://gps.press/sop-data/208.06-att-18/
  19. Staff Guide on the Prevention and Reporting of Sexual Misconduct with Offenders
     URL: https://gps.press/sop-data/208.06-att-19/

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FULL TEXT:
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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.