Restraining Order Evidence Checklist Form
Use this form to organize incident details and the evidence you have gathered for a restraining order case.
Case Overview
Name or initials of person preparing the checklist
*
First Name
Middle Name
Last Name
Preferred contact email
example@example.com
Preferred contact phone
Please enter a valid phone number.
Format: (000) 000-0000.
Case reference name or internal case label
*
Date checklist completed
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Incident Summary
Incident Date or Date Range
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
General Location of Incident(s)
*
Brief Description of What Happened
*
Current Stage or Frequency of Incidents
Please Select
Single incident
Repeated incidents
Ongoing
Escalated recently
Decreased recently
Other
Evidence Checklist
Evidence types available
*
Photos
Screenshots
Text messages
Call logs
Emails
Witness statements
Police reports
Medical records
Video recordings
Audio recordings
Journal or log entries
Other
Where is the evidence stored or how can it be accessed?
Submit
Should be Empty: