Case Information

NOTICE: This survey is being conducted to evaluate the City Prosecutor’s Office Victim Services Program; not the Surprise City Court or Police Department. The information provided about you and your case is confidential.

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* 1. Please list the crime(s) committed against you:

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* 2. Did any of the crime(s) committed involve Domestic Violence?
(Please see the definition of “Domestic Violence” below prior to answering.)

“Domestic Violence” refers to the relationship between the victim and defendant (person who committed the crime). Please answer “yes” to this question if the relationship between the victim and defendant in this case meet any of the following:
  • The victim and defendant are or were previously married 
  • The victim and defendant reside together or previously resided together in the same household
  • The victim and defendant have a child in common or one party is pregnant by the other
  • The victim is related to the defendant or defendant’s spouse by blood or court order as a parent, grandparent, child, grandchild, brother or sister or by marriage as a parent-in-law, grandparent-in-law, stepparent, step-grandparent, step-child, step-grandchild, brother-in-law or sister-in-law
  • The victim is a child who resides or has resided in the same household as the defendant and is related by blood to a former spouse of the defendant or to a person who resides or who has resided in the same household as the defendant 
  • The relationship between the victim and defendant is or was previously a romantic or sexual relationship
Arizona Revised Statute § 13-3601

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* 3. Were you contacted at least once by mail or telephone by a representative from the City Prosecutor’s Office Victim Services Program?

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