VICTIM WAIVER TO RELEASE INFORMATION

Dear Victim,

Following a traumatic event, victims often experience stress, confusion, fear, and many other emotions. The Irvine Police Department works in collaboration with a wide range of victim service providers who are trained to provide continuous support, guidance, and counseling to you during this difficult time. We are requesting your consent to release your name and telephone number to a trained victim advocate who will contact you and offer a variety of services designed to assist you. These services include, but are not limited to, crisis counseling, assistance in obtaining emergency shelter, food or clothing, assistance in obtaining a restraining order, answering questions about the criminal justice process, and assistance in filling for restitution. Your consent will expedite the process of providing you support as your case progresses through the criminal justice system.

hereby authorize the Irvine Police Department to release my name, address, and telephone number to a Victim Advocate chosen by the Irvine Police Department for the sole purpose of allowing the Victim Advocate to contact me regarding possible representation. I understand that the Irvine Police Department will continue to protect and maintain the confidentiality of my name, address, and telephone number pursuant to Penal Code section 293 and Government Code Section 6254(f), and that this authorization shall not affect the confidentiality of such information in any manner beyond what I have specifically authorized above. In addition, I hereby voluntarily waive any claims or causes of action against the Irvine Police Department, its officers, and employees that may result from the release of my name, address, and telephone number to the Victim Advocate.