Dependable Access for Victims' Expenses
Your Contact Information
I Am:
select
a Victim/Claimant
a Provider of service (doctor, hospital, funeral home, etc.)
from a Victim Service Program
from a Justice Organization (Police, DA, Courts)
Other
Name:
Name is required.
Email Address:
A valid Email Address is required.
An Email Address is required.
Phone:
A Phone Number is required.
A complete and valid Phone Number is required.
Claim Number:
If you have filed a claim, please include your claim number.
Your Question
Question Category:
select
General Help
Password Help
On-line Claim Form
Claimant Inquiry
Provider Inquiry
Materials Ordering Request
VSP Interview Mode
Technical Support / Error Page
Other
Question:
A Question is required.
If you prefer to scan and email claim documents, rather than mailing/faxing the documents, you may send the documents to
ra-davesupport@pa.gov
Please send technical comments and problems to
DAVE Support
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