Victim Impact Statement - Mchenry County State'S Attorney Page 2

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Emotionally - how has this crime affected you?
o Describe any psychological or emotional suffering which occurred as a result of the incident.
Describe any counseling or therapy you have received as a result of the incident. Describe ways
this incident has affected your relationship with your family, friends, and coworkers.
Medically – how has this crime affected you?
o Describe any physical injuries suffered as a result of the incident including extent, seriousness,
and permanence. Describe any medical treatment that was needed including the type and
length of treatment as well as adjustments you’ve made as a result of the injuries.
Economically – how has this crime affected you?
o Describe any impact from damaged, destroyed or stolen property. Describe what effect the
incident has had on your ability to earn a living including number of days lost from work and
income lost. (There is a separate form for restitution requests.)

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