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Domestic Violence Referral & Monitoring form (DV1 form)

Guidance on completeing the DV1 form

 What is the DV1 referral and monitoring form?

  • The Domestic Violence Referral & Monitoring Form (DV1 Form) is a multi-agency referral and monitoring form for frontline support, evidencing & monitoring domestic abuse
  • It provides a common framework for assessing the victim’s needs for protection and support and identifying appropriate referrals.
  • It helps to ensure consistent recording and referral of DV cases.

Why do I need to complete the DV1?

  • If the victim would like a referral to a frontline service for specialist domestic violence support and/or the incident monitored. 
  • On completion the originating referrer must read the Privacy Notice to the victim to ensure they are aware of what will be done with information disclosed. 
  • It provides essential information to assist agencies to support the victim.
  • It reduces the need for victims to repeat information to staff.

What do I say to the victim?

“We are committed to tackling domestic abuse and take it very seriously. In order for us to be able to support and signpost you, we will need to take down some personal information and complete a DV reporting form. Data protection requirements state we need to seek permission first before doing this and to also then be able to share your personal information to other agencies. Please note that should we be made aware of any information that highlights that yours or others safety and/or life is at risk, this information will be processed without consent.  Please refer to the Privacy Notice on the council's website.

Do you understand that by engaging with this service, your data will be shared with internal, external and third party organisations where required?

I can provide you with a copy of the form if you wish to keep one.”

Completing the DV1 Form

  • The DV1 form should be completed while interviewing the victim, either in person or on the telephone.
  • Please complete electronically where possible and if completing by hand please ensure that handwriting is legible.
  • All boxes must be completed. If requested information is not known, then please state ‘not known’.
  • The form provides a basic structure for an interview. You may find that you already have some of the information.
  • As the referrer it is your responsibility to refer the client to the specialist support services if this is what they want. If you need more information please see the Violence Against Women and Girls directory for professionals

What happens once I have completed the DV1?

  • Email the DV1 Form to Victim Support Tower Hamlets (VSTH) Independent Domestic Violence Advocate (IDVA) vs.towerhamlets@victimsupport.cjsm.net or Tel: 020 7364 2448
  • If victim does not require IDVA support, refer them to the appropriate service using the Domestic Violence Service Directory.
  • It is the responsibility of the referrer to ensure all DV1s completed are secured in line with data protection and handling procedures.