Restorative & Transformative Justice HUB

 

Please fill out the form below with the information you have at this time of the potential RTJ participant.



DOB (enter as mm/dd/yyyy):




Male/Female:
Race/Ethnicity:
Primary Language Spoken:

Name of Person Linking Participant:
Organization:
Position:
Phone Number of Person Linking Participant:
Email of Person Linking Participant::


Additional Information


Why are you linking this potential participant?
Is there a particular incident or conflict to be addressed? Please give details if possible.
In instances involving cases which have gone to court only: Has the potential participant been provided with additional court ordered/community conditions?
Yes:
No:
Please add details:
Has an information brochure been provided and explained?
Yes:
No:
Has there been any previous action taken around this incident or participant(s)? Are there other agencies involved? Please write the contact information below. Please remember that RTJ is only a part of the solution and ensure that you have made appropriate connections through our own Community Safety Partnership, safeguarding etc. as well.
Please add any comments/further info that you think are important to this linkage. Please also attach any relevant information (particularly involving risk).