This website is for use by legal professionals (lawyers and law practices) only. If the information is used incorrectly, you could risk losing money or your legal rights. If you are a member of the public looking for free advice about your legal problems please visit legalaid.vic.gov.au, or contact our Legal Help advice line on 1300 792 387, Monday to Friday from 8 am to 6 pm. 

If you decide to use or rely on the information or make decisions based on the information in this website (which VLA does not recommend) VLA is not liable to you or any third party in any way for any loss, damage, costs or expenses you or they may suffer or incur as a result.

Forms for family violence intervention orders

Where to find relevant intervention order forms.

Information forms to accompany interim and final family violence orders

From 21 July 2019, the Magistrates' Court is issuing information sheets to respondents and affected family members with all interim and final family violence intervention orders.

See Information sheets for interim and final family violence orders(opens in a new window).

These new forms are prescribed in the Magistrates' Court (Family Violence Protection) Rules 2018:

  • Form 1A—Explanation of interim family violence intervention order
  • Form 1B—Explanation of final family violence intervention order
  • Form 2—Application for rehearing

See Magistrates' Court (Family Violence Protection) Rules 2018 (Vic)(opens in a new window).

Applying for an intervention order

To apply for an intervention order for an applicant or an additional applicant fill in the following forms:

From 16 June 2020 all courts will be accepting online applications:

See Magistrates` Court—(online)Family violence intervention order application(opens in a new window).

To apply for an associated final order for an additional applicant or respondent fill in the following forms:

To apply to extend, vary or revoke an intervention order, an applicant must fill in:

Applying to be deemed a non-prohibited person

If a person is deemed to be a prohibited person because an intervention order has been made against them because of a criminal determination, they can make an application to the Magistrates' Court to be permitted to hold a firearms licence.

See Magistrates' Court—Firearms Act – Application to be deemed a non-prohibited person(opens in a new window).

Examples of family violence applications

There are 2 examples of family violence application forms at the foot of this page. In one of these forms the applicant is a member of the police force, in the other the applicant is an affected family member.

Download at Family violence safety notices.

Example of a family violence final order

Download at Family violence safety notices.

Applying to have fines dealt with under the Family violence Scheme

Department of Justice and Community Safety

The Department site has information about the family violence scheme and links to application form.

See Fines Victoria—Family violence scheme(opens in a new window).

Family violence safety notices

Family violence safety notices are issued by police. The forms contain four sheets. One copy is handed to the respondent(blue), one to the protected person (brown), the original is filed in the court (green) and the 4th copy is retained by police (black).

Intervention order (pdf, 165 KB)(opens in a new window)

Example of a final intervention order from a magistrates' court.

Family violence application by affected family member (docx, 25 KB)(opens in a new window)

Example of an application for a family violence order where the applicant is the affected family member.

Family violence application by police (docx, 25 KB)(opens in a new window)

Example of an application for a family violence intervention order where the applicant is a member of the police force.

Family Violence Safety Notice—Respondent copy (pdf, 2.5 MB)(opens in a new window)

An example of a family violence safety notice that is issued to a respondent.

Family Violence Safety Notice—Protected person copy (pdf, 2.4 MB)(opens in a new window)

An example of a Family Violence Safety notice that is issued to the protected family member.

Family Violence Safety Notice—Court copy (pdf, 638 KB)(opens in a new window)

An example of the court copy of a family violence safety notice.

Family Violence Safety Notice—Police copy (pdf, 819 KB)(opens in a new window)

An example of family violence safety notice that is retained by police.

Updated