If you are in an unsafe situation or need help, please call 970-824-2400

Thank you for participating in this quick survey. Your answers are confidential and will be used to help Open Heart Advocates gauge community awareness of the options and services that are available in Moffat County for victims of sexual assault.
Feel free to skip questions that do not apply to you.

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* 1. What is your age range

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* 2. Which gender do you identify with?

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* 3. Do you live in Moffat County?

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* 4. In the Craig/Moffat County area, have you ever been

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* 5. If YES, did you report it to (please check all that apply)

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* 6. If you are under the age of 15, have you ever had sex with anyone over the age of 18?

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* 7. If yes, was it voluntary?

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* 8. If it was against your will, were you given drugs or alcohol? (That you know of)

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* 9. If you were sexually assaulted in Colorado, you have different reporting options. Which of the following are you familiar with? (Check all that apply)

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* 10. Do you know how Open Heart Advocates can help you if you are drugged/sexually assaulted?

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* 11. Would you like to receive more information from Advocates about what we do and how we can help if you or someone you know ever experiences sexual assault or intimate partner violence? If Yes, please include your phone number here.

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* 12. Is there anything else you would like us to tell us?

0 of 12 answered
 

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