Victim/Claimant Satisfaction Survey for the Victims Compensation Program

Question Title

* 1. How likely is it that you would recommend the Crime Victims Compensation Program to a friend or colleague?

NOT AT ALL LIKELY

EXTREMELY LIKELY

0

1

2

3

4

5

6

7

8

9

10

0

1

2

3

4

5

6

7

8

9

10

Question Title

* 2. Overall, please rate your experience with the Program?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

Question Title

* 3. Overall, please rate your interaction(s) with the staff?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

Question Title

* 4. How responsive has the staff been to your questions or concerns about your claim?

Extremely responsive

Very responsive

Somewhat responsive

Not so responsive

Not at all responsive

Not applicable

Question Title

* 5. Have you received funds or have your bills related to the victimization been paid by the Program?

Yes

No

Question Title

* 6. When did you first apply to the Program?

Less than one month

Less than six months

Six months to a year

1 - 2 years

3 or more years

I haven't submitted an application yet.

Question Title

* 7. Is there anything that could have been done to improve your experience with the Program?

No (please explain)

Yes (please explain)

Comments

Question Title

* 8. Completing the below is NOT required.

Name

Claim Number

Email Address

Phone Number