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Victim's Request to Receive Notifications from Department of Behavioral Health and  Developmental Disabilities


As the victim1 of a crime allegedly committed by the person named below who is committed to the Department of Behavioral Health and Developmental Disabilities (DBHDD), I would like to receive notifications from DBHDD when the committed person:

  • Is discharged from a DBHDD hospital or designated secure facility for competency restoration of juveniles.
  • Escapes from such a DBHDD facility.
  • Is subsequently readmitted to such a DBHDD facility.

I understand that I will not receive any notifications unless I ask to receive them, by completing and returning the original of this form to the address indicated below. I understand that if my address or telephone number changes in the future, I am responsible for contacting DBHDD at the address or telephone number below to give DBHDD my new address or telephone number.

I understand that this procedure does not entitle me to receive any additional information about the accused person named below. I understand that DBHDD will not inform me of the location or whereabouts of the accused person named below.

If my address or telephone number(s) changes, it is my responsibility to give my new information to:

Director of Forensic Services
Georgia Department of Behavioral Health and Developmental Disabilities
2 Peachtree Street, N.W. Suite 23-493
Atlanta, Georgia 30303
Fax: 770-359-3042
Email: victimnotification@dbhdd.ga.gov
Website: http://dbhdd.georgia.gov

Name of accused person

First
 

 Last
  
 

County where case was tried:
  

Name of victim

First
  

Last
 
 

Advocate for victim

First
 

Last

Street Address

City
 

State
 

Zip Code

 Email Address:

Phone number:

 

Person to be notified

First
  

Last
 
 

Relationship to victim:
 
If other, please enter relationship: 

Street Address:
 

City
  

State
  

Zip Code
 

Phone Numbers (provide at least one):
Home

Work

Cell

Signature

By typing my name below, I consent to be notified when the accused person listed above is discharged, escapes, or is readmitted to a DBHDD facility. If my address or telephone number(s) changes, it is my responsibility to give my new information to the DBHDD office listed above.

 

1 "Victim" means a person against whom a crime has been perpetrated. In the event of the death of the victim, “Victim” will include the following persons (but not if they are the accused person or are in custody for an offense): spouse; adult child if there is no spouse; parent if there is no spouse or adult child; sibling if there is no spouse, adult child or parent; grandparent if there is no spouse, adult child, parent or sibling. If the victim is a minor, the parent, custodian or court appointed guardian may request to receive notifications (but not if he/she is the accused person or is in custody for an offense). If the victim has a guardian appointed in writing by a Judge, the guardian may request to receive notifications (but not if he/she is the accused person or is in custody for an offense). See OCGA § 17-17-3(11).