STATIC-99 TALLY SHEET

Subject Name: ____________________________________________ Place of Scoring: __________________________________________ Date of Scoring: ____________

Question Number 1 2 Risk Factor Young Ever Lived With

Name of Assessor: ___________

Codes Aged 25 or older Aged 18 24.99 Ever lived with lover for at least two years? Yes No No Yes No Yes Charges Convictions None 1-2 3-5 6+ 3 or less 4 or more No Yes No Yes No Yes No Yes None 1 2-3 4+ Score 0 1

3 4 5

Index non-sexual violence Any Convictions? Prior non-sexual violence Any Convictions? Prior Sex Offences

0 1 0 1 0 1

6 7 8 9 10

Prior sentencing dates (excluding index) Any convictions for non-contact sex offences Any Unrelated Victims Any Stranger Victims Any Male Victims

0 1 2 3 0 1 0 1 0 1 0 1 0 1

Total Score individual risk

factors
POINTS 0,1 2,3 4,5 6+

Add up scores from

Suggested Nominal Risk Categories

Risk Category Low Moderate-Low Moderate-High High