1. Introduction

Thank you for choosing to participate in this survey. Participation is voluntary, anonymous, and confidential. We appreciate that you have taken the time to help us improve the quality of our services.

* 1. On what date did you access our 24-hour hotline?


* 2. How quickly did the on-call advocate return your call?

* 3. Upon returning your initial call, was the advocate courteous and professional?

* 4. Did the advocate help identify a support system with you?

* 5. Did the advocate discuss your next steps/plan of action following this hotline call?

* 6. If appropriate, were you provided with a list of referrals?

* 7. What were you looking for when initially making the call to the 24-hour hotline? (Please check all that apply.)

* 8. What is your gender?

* 9. What is your age?

* 10. Please feel free to add any additional comments you would like the staff to consider.