Support Services and Advocacy Feedback Form

Your input will help us improve our services.  Please answer honestly.  Your answers are confidential and very important to us.  Once finished, please drop it in survey box the advocate showed you.  

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* 1. I know more ways to plan for my safety

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* 2. I know more about community resources

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* 3. I know more about my rights and options

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* 4. I am more hopeful about my future

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* 5. I am more comfortable asking for help

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* 6. I am more confident in my decision making

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* 7. Please circle the number that best reflects your agreement or disagreement with the following statements

  Strongly agree Agree Disagree Strongly Agree
Program staff treated me with respect
Program staff were caring and supportive
I feel staff was non-judgemental
My experience with the program was very helpful
I would recommend others to the program

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* 8. Where did you hear about the program's available services?

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* 9. Is there anything you feel the program could do to improve our advocacy/support services or a way RDAP services could be more convenient for you?

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* 10. Was there a need that the program couldn't provide for you

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