Advocacy Experience Survey

NH Coalition Against Domestic & Sexual Violence

Before You Begin

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About this Survey

This survey asks questions about the services you have received through a NH crisis center and how beneficial the services have been to you.

This anonymous survey takes approximately 5 minutes to complete.
The survey does not ask for any information that can identify you or the device you are using.
Your responses are voluntary. You can skip any question you do not wish to answer.
Completed surveys are compiled by NH Coalition staff and shared only with the crisis center you worked with.

Thank you for your feedback!

Question Title

* 1. What crisis center did you work with?

Bridges: Domestic & Sexual Violence Support

Crisis Center of Central NH

HAVEN

Monadnock Center for Violence Prevention

New Beginnings without Violence and Abuse

REACH at YWCA NH

RESPONSE to Sexual & Domestic Violence

SHARPP

Starting Point: Services for Victims of Domestic & Sexual Violence

Turning Points Network

Voices Against Violence

WISE

Question Title

* 2. How did you hear about the crisis center?

Question Title

* 3. Where did you most recently work with an advocate?

Crisis Center Office

Court

Hospital

My Home

Police Station

Shelter

Support Group

Other (please specify)

Question Title

* 4. Are you currently or have you recently lived in the crisis center's shelter?

Yes

Question Title

* 5. Based on your experience with the crisis center, please indicate what feels true to you:

	Not at all	Somewhat	A lot	Does not apply to me
I feel more hopeful about the future	I feel more hopeful about the future Not at all	I feel more hopeful about the future Somewhat	I feel more hopeful about the future A lot	I feel more hopeful about the future Does not apply to me
I know more about community resources I might need	I know more about community resources I might need Not at all	I know more about community resources I might need Somewhat	I know more about community resources I might need A lot	I know more about community resources I might need Does not apply to me
I have more ways to plan for my safety and future	I have more ways to plan for my safety and future Not at all	I have more ways to plan for my safety and future Somewhat	I have more ways to plan for my safety and future A lot	I have more ways to plan for my safety and future Does not apply to me
I feel less alone	I feel less alone Not at all	I feel less alone Somewhat	I feel less alone A lot	I feel less alone Does not apply to me
I know more about systems I may be involved with (legal, DCYF, social services, job training, benefits, etc)	I know more about systems I may be involved with (legal, DCYF, social services, job training, benefits, etc) Not at all	I know more about systems I may be involved with (legal, DCYF, social services, job training, benefits, etc) Somewhat	I know more about systems I may be involved with (legal, DCYF, social services, job training, benefits, etc) A lot	I know more about systems I may be involved with (legal, DCYF, social services, job training, benefits, etc) Does not apply to me
I feel comfortable reaching out in the future or connecting friends who might need support	I feel comfortable reaching out in the future or connecting friends who might need support Not at all	I feel comfortable reaching out in the future or connecting friends who might need support Somewhat	I feel comfortable reaching out in the future or connecting friends who might need support A lot	I feel comfortable reaching out in the future or connecting friends who might need support Does not apply to me
I have a plan to help me meet my financial and housing needs	I have a plan to help me meet my financial and housing needs Not at all	I have a plan to help me meet my financial and housing needs Somewhat	I have a plan to help me meet my financial and housing needs A lot	I have a plan to help me meet my financial and housing needs Does not apply to me

Question Title

* 6. From your contact with this agency, what community resources were you connected to? (check all that apply)

Victims' Compensation

Transportation

Food

Legal Services

Medical Care for Myself and/or my Children

Education

Immigration Services

Parenting or Child Care Resources

Employment Services

Financial Assistance

Substance Abuse Services

Housing and/or Household Items

Additional Crisis Center Services

Social Support or Community Connections

Counseling and Mental Health Support

Other (please specify)

Question Title

* 7. Are there any other concerns, comments, or suggestions that you'd like to share? (please do not include any personally identifiable information like your name, phone number, email, or address)