Initial Survey Assessment

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The East Valley Regional Veterans Court (RVC)  helps resolve Veterans misdemeanor and other violations for everything from trespassing and disorderly conduct to domestic violence and DUI. Many Veterans need assistance addressing homelessness, substance abuse, mental health, anger management and conflict resolution issues.

Each Veteran must agree to a case plan that may include counseling or treatment, in order to work on the issues that may be holding them back in civilian life. Social service agencies and the Department of Veterans Affairs collaborate with the court to create a customized plan for each veteran.  Successful completion fro the program may result in a dismissal of the charges in certain cases or a reduction in sentence. 


RVC Intake Info:

By submitting this information, I understand and agree the information I provide will be used to determine appropriate referrals to resources and services for my case.  The complete survey or individual answers will not be shared with the court, prosecutors, or the judge.  A brief summary will be developed and used to inform the court about what you shared in this summary. 

Answering the full survey honestly will help ensure the East Valley Regional Veteran's Court will be able to develop and compile the most effective resources for my case.

 

  


1
What court referred you to East Valley Veteran's Court? (Click All that Apply)
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What court referred you to East Valley Veteran's Court? (Click All that Apply)

2

Do you have any pending court cases any other jurisdiction?  If so, please list the court(s). 


3
Full Name: (Last, First)

4
Gender:
Gender:

5
Current Street Address:
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City:
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State:
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Zip Code:

9
Phone Number:

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Email Address:

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Date of Birth:
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Last 4:

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Primary Language:

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Marital Status:
Marital Status:

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Dependants:
Dependants:

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LGBTQ+:
LGBTQ+: