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Survivor Survey
Non-Residential
1.
What Survivor Advocacy Center services did you receive
Counseliing
Advocacy
Case Management
Assistance with Family Court Petition
Support Group
2.
The Survivor Advocacy Center Staff treated me with respect and courtesy
Yes
No
*
3.
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
4.
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
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
5.
Is there anything the program can do to improve?
Yes
No
If yes, please describe:
6.
How did you hear about our program:
Internet Search
Social Media
Poster/Flyer
Another Agency
Family/Friend
Other
7.
Additional comments:
Current Progress,
0 of 7 answered
