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Survivor Survey
Residential
1.
Check all that apply:
Staff made me feel welcome
Staff treated me with respect
Other residents made me feel welcome
Space felt comfortable
*
2.
As a result of working with the Survivor Advocacy Center:
(Required.)
I know more ways to plan for my safety
I know more about community resources
I'm more confident in my decision making
I'm more hopeful for my future
I'm more comfortable asking for help
I know more about my rights and options
3.
Please rate the Survivor Advocacy Center on the following:
Doesn't Apply
Strongly Disagree
Disagree
Agree
Strongly Agree
Staff were caring and supportive
Doesn't Apply
Strongly Disagree
Disagree
Agree
Strongly Agree
Staff spent enough time with me talking about my safety
Doesn't Apply
Strongly Disagree
Disagree
Agree
Strongly Agree
Staff spent enough time talking with me about my children's safety
Doesn't Apply
Strongly Disagree
Disagree
Agree
Strongly Agree
My religious and spiritual beliefs were respected
Doesn't Apply
Strongly Disagree
Disagree
Agree
Strongly Agree
My sexual orientation, gender identity or gender expression were respected
Doesn't Apply
Strongly Disagree
Disagree
Agree
Strongly Agree
My racial/ethnic background were respected
Doesn't Apply
Strongly Disagree
Disagree
Agree
Strongly Agree
4.
Is there anything the program can do to improve?
Yes
No
If yes, please describe:
5.
How did you hear about our program:
Internet Search
Social Media
Poster/Flyer
Another Agency
Family/Friend
Other
6.
Additional comments:
Current Progress,
0 of 6 answered