Crisis Response Evaluation Question Title * 1. Please select the DVAC site which provided the service Ipswich Region Service Toowoomba Region Service Question Title * 2. Date Date Date Question Title * 3. Approximately, how many times have you contacted us or had appointments? Question Title * 4. What type of service did you have? Crisis Support Emotional Support Safety Planning Court Support DV Education Case Management Safety Upgrades Keeping Women Safe In Their Homes Question Title * 5. Did you feel heard, understood and respected by your worker? Not at all Somewhat Moderately Mostly Absolutely Not at all Somewhat Moderately Mostly Absolutely Question Title * 6. Did you feel comfortable speaking with your worker? Not at all Somewhat Moderately Mostly Absolutely Not at all Somewhat Moderately Mostly Absolutely Question Title * 7. Was your worker’s approach a good fit for you? Not at all Somewhat Moderately Mostly Absolutely Not at all Somewhat Moderately Mostly Absolutely Question Title * 8. Did you feel listened to and able to talk about what you wanted? Not at all Somewhat Moderately Mostly Absolutely Not at all Somewhat Moderately Mostly Absolutely Question Title * 9. Overall, has your quality of life improved since coming to the Crisis team? Not at all Somewhat Moderately Mostly Absolutely Not at all Somewhat Moderately Mostly Absolutely Question Title * 10. Since coming to the Crisis team, do you feel more able to deal with the current challenges in your life? Not at all Somewhat Moderately Mostly Absolutely Not at all Somewhat Moderately Mostly Absolutely Question Title * 11. Do you feel safer/more protected from harm? Not at all Somewhat Moderately Mostly Absolutely Not at all Somewhat Moderately Mostly Absolutely Question Title * 12. What do you feel you benefitted most from? Question Title * 13. Is there anything that could be done differently in our team? Question Title * 14. Is there any feedback you would like to give to your worker? Question Title * 15. Do you have any further comments about your experience at the service? Thank youWe appreciate your feedback about our service. Please do not hesitate to contact us with any further suggestions regarding ways we can improve our service to you. Done
