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Human Trafficking Experience Survey
General Information
Please complete this survey regarding your experience with human trafficking.
1.
Age:
2.
Gender
Female
Male
Other (please specify)
3.
Race (choose all that apply)
American Indian, Alaskan Native
Asian
Black, African American
Native Hawaiian, Pacific Islander
White
Other (please specify)
4.
Ethnicity
Hispanic or Latina
Not Hispanic or Latina
Other (please specify)
5.
Location (City/State):
6.
What type of trafficking did you experience (check all that apply)?
Sex trafficking
Labor trafficking
Other (please specify)
7.
How old were you when you first experienced trafficking
Child (under the age of 10)
Adolescent (age 10-17)
Adult 18+
8.
Did the trafficker or anyone else in your trafficking experience ever strangle or attempt to strangle you?
Yes
No
I'm unsure
9.
If so, did you seek medical attention?
Yes
No
I'm unsure
