This information is being collected so that we have feedback from survivors of sexual assault in Perth County.  We plan to use the survey results to support the community's desire for improved sexual assault services in Perth County.

The survey is anonymous.  You will not be required to submit your name or any identifiable information.

Feel free to call Optimism Place Women's Shelter and Support Services at 519-271-5550, toll free 1-800-265-8598, or the Emily Murphy Centre at 519-271-7350 if you need any support after completing this survey.  

* 1. Who did you contact after you were sexually assaulted?

* 2. Did you go to the hospital for treatment?

* 3. If you did not go to the hospital after the assault, can you explain why?

* 4. Did you go to London or Kitchener to have a Sexual Assault Evidence Kit completed?

* 5. Would you have preferred to have the choice to have the Sexual Assault Evidence Kit done locally?

* 6. Is there anything else that you would like to share about your experience?