DV 101 Feedback Form

Question Title

1. What are your key takeaways from this training?

Question Title

2. How effective was the training in increasing your understanding of domestic abuse?

Very effective

Somewhat effective

Neutral

Somewhat ineffective

Very ineffective

Comments:

Question Title

3. Please rate your level of agreement with the following statements:

	Strongly Disagree	Somewhat Disagree	Neutral (Neither Agree nor Disagree)	Agree	Strongly Agree
I know steps I should take if someone discloses abuse to me.	I know steps I should take if someone discloses abuse to me. Strongly Disagree	I know steps I should take if someone discloses abuse to me. Somewhat Disagree	I know steps I should take if someone discloses abuse to me. Neutral (Neither Agree nor Disagree)	I know steps I should take if someone discloses abuse to me. Agree	I know steps I should take if someone discloses abuse to me. Strongly Agree
I understand the barriers that survivors face in disclosing abuse and ways to help overcome those barriers.	I understand the barriers that survivors face in disclosing abuse and ways to help overcome those barriers. Strongly Disagree	I understand the barriers that survivors face in disclosing abuse and ways to help overcome those barriers. Somewhat Disagree	I understand the barriers that survivors face in disclosing abuse and ways to help overcome those barriers. Neutral (Neither Agree nor Disagree)	I understand the barriers that survivors face in disclosing abuse and ways to help overcome those barriers. Agree	I understand the barriers that survivors face in disclosing abuse and ways to help overcome those barriers. Strongly Agree
I am aware of ways to support survivors and foster resilience in children exposed to domestic abuse	I am aware of ways to support survivors and foster resilience in children exposed to domestic abuse Strongly Disagree	I am aware of ways to support survivors and foster resilience in children exposed to domestic abuse Somewhat Disagree	I am aware of ways to support survivors and foster resilience in children exposed to domestic abuse Neutral (Neither Agree nor Disagree)	I am aware of ways to support survivors and foster resilience in children exposed to domestic abuse Agree	I am aware of ways to support survivors and foster resilience in children exposed to domestic abuse Strongly Agree

Question Title

4. Which actions do you plan to take following this workshop? (Select all that apply)

Refer individuals to appropriate services

Host staff trainings about domestic abuse and healthy relationships.

Develop policies for responding to domestic abuse (e.g., referral protocols, financial aid policies, safety protocols)

Display and distribute informational materials (flyers, posters, etc.)

Host a domestic violence resource landing page on our website

Launch social media campaigns to raise awareness

Host more community conversations about domestic abuse

Develop partnerships with local domestic violence programs

Collaborate with other organizations around addressing the needs of survivors

Other (please specify)

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5. What areas of the workshop do you feel could be improved?

Question Title

6. Are you interested in any additional resources or workshops? Select all that apply.

Staff training

Healthy relationship training

One-on-one consultation

Social media toolkits

Recommended safety protocols

Restroom flyers

If you are interested in any resources or workshops, please provide your name:

DV 101 Feedback Form

Question Title

1. What are your key takeaways from this training?

Question Title

2. How effective was the training in increasing your understanding of domestic abuse?

Question Title

3. Please rate your level of agreement with the following statements:

Question Title

4. Which actions do you plan to take following this workshop? (Select all that apply)

Question Title

5. What areas of the workshop do you feel could be improved?

Question Title

6. Are you interested in any additional resources or workshops? Select all that apply.

Question Title

7. Would you like a certificate of participation? (If yes, please provide your name):

Question Title

8. Additional Comments

DV 101 Feedback Form

Question Title

* 1. What are your key takeaways from this training?

Question Title

* 2. How effective was the training in increasing your understanding of domestic abuse?

Question Title

* 3. Please rate your level of agreement with the following statements:

Question Title

* 4. Which actions do you plan to take following this workshop? (Select all that apply)

Question Title

* 5. What areas of the workshop do you feel could be improved?

Question Title

* 6. Are you interested in any additional resources or workshops? Select all that apply.

Question Title

* 7. Would you like a certificate of participation? (If yes, please provide your name):

Question Title

* 8. Additional Comments

1. What are your key takeaways from this training?

2. How effective was the training in increasing your understanding of domestic abuse?

3. Please rate your level of agreement with the following statements:

4. Which actions do you plan to take following this workshop? (Select all that apply)

5. What areas of the workshop do you feel could be improved?

6. Are you interested in any additional resources or workshops? Select all that apply.

7. Would you like a certificate of participation? (If yes, please provide your name):

8. Additional Comments