DV 101 Feedback Form
1.
What are your key takeaways from this training?
2.
How effective was the training in increasing your understanding of domestic abuse?
Very effective
Somewhat effective
Neutral
Somewhat ineffective
Very ineffective
Comments:
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.
Strongly Disagree
Somewhat Disagree
Neutral (Neither Agree nor Disagree)
Agree
Strongly Agree
I understand the barriers that survivors face in disclosing abuse and ways to help overcome those barriers.
Strongly Disagree
Somewhat Disagree
Neutral (Neither Agree nor Disagree)
Agree
Strongly Agree
I am aware of ways to support survivors and foster resilience in children exposed to domestic abuse
Strongly Disagree
Somewhat Disagree
Neutral (Neither Agree nor Disagree)
Agree
Strongly Agree
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)
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.
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:
7.
Would you like a certificate of participation? (If yes, please provide your name):
8.
Additional Comments
