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Notice of Collection of Personal Information

Personal information (including name, date of birth, gender, preferred language, contact information, crime information and services requested), which has been provided to apply to the Victim Quick Response Program (VQRP), will be collected and used by the Ministry of the Attorney, Victims and Vulnerable Persons Division, the Service Delivery Organization and their authorized representatives, or as otherwise required by law, to administer the VQRP.  This includes processing, assessing and verifying the information provided.  Please be advised that the VQRP may contact the signatory, the Service Delivery Organization, the referral source or other government programs for the purpose of completing, clarifying or verifying the information provided for this application.

Personal information is collected under the authority of section 5(4) of the Victims’ Bill of Rights, 1995 and section 5 of the Ministry of the Attorney General Act.  If you have any questions about the collection and use of your information, please contact the Victim Quick Response Program Coordinator at:

Victim Quick Response Program
31 Adelaide St. E,
PO Box 45, Toronto ON M5C 2J5
Phone: 416-326-2546; toll free: 1-866-320-3350

Declaration and Consent

  • I hereby consent to the collection and sharing of the information provided for this application for the administration of the Victim Quick Response Program (the “program”).  
  • I understand that, except as required by law, personal information will be disclosed only for the purposes of administering the program, as described above, or for the administration of other government programs, such as Ontario Works, the Ontario Disability Support Program or the Criminal Injuries Compensation Board.
  • I hereby declare that I have not received, and will not be receiving, financial assistance for the same services and/or expenses contained in this request from any of the following sources:
Private insurance plan Ontario Works
Workplace Safety and Insurance Board      Ontario Disability Support Program
Criminal Injuries Compensation Board     Employee Benefits
Other publicly-funded services
  • I hereby declare that I have no other recourse or financial resource to address this immediate need.
  • I hereby agree that, if I am approved for the program, I will follow the program’s terms and restrictions.
  • I hereby declare that all of the information I have provided for the purposes of this application are, to the best of my information and belief, true, correct, and complete.
  • I hereby declare that the service provider is selected by me and I therefore release the Ministry of the Attorney General and the Service Delivery Organization from any quality of service guarantee.
  • If I have voluntarily selected email as my preferred method of communication with the program, I am aware that the program cannot guarantee the privacy or confidentiality of any information that is sent over the internet by email as it may not be free from interception by third parties.  Knowing this, I hereby consent to this method of contact and agree to accept any associated risks.
Signature and Identifying Information
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