SOP 208.06-att-14: PREA Counseling Referral Form
Summary
Key Topics
- PREA
- sexual victimization
- sexual assault
- counseling referral
- risk screening
- PREA allegation
- victim services
- aggressor
- inmate counseling
- retaliation prevention
- mental health services
Full Text
SOP 208.06
Attachment 14
06/23/22
# GEORGIA DEPARTMENT OF CORRECTIONS PREA Counseling Referral Form
Reason for referral:
`☐` Risk Screening
The agency shall offer counseling to any offender with prior history of sexual victimization or
aggressiveness within 14 days of risk screening.
Date of Screening: ________________ Date of Counseling Referral: ________________
`☐` PREA Allegation
The agency must offer counseling services to named victims and aggressors in any PREA
allegation.
Select one:
I _DO_ accept the offer of counseling services.
I _DO NOT_ accept the offer of counseling services.
This is to acknowledge I understand I have the right to counseling services. I further understand
this is a voluntary service and I cannot be retaliated against for refusal to participate.
______________________________ _____________________
Offender Name GDC #
______________________________ _____________________
Signature Date
Record Retention: Retain permanently in the offender’s institutional file. If the referral is from a PREA allegation a
copy is placed in the investigative file.