WDVS Awareness Walk Survey

Thank you for participating & completing the following survey. The following questions are optional, as they may be sensitive. WDVS would like to inform participants that answers are confidential & only WDVS staff have access to the information. This survey is to give staff insight on what services would be helpful to offer to the community in reducing violence in Glenn County. 

Question Title

* 1. What have you heard about Westside Domestic Violence Shelter?

Question Title

* 2. Has COVID-19 impacted your family relationships? If yes, please explain.

Question Title

* 3. Do you receive CalWorks?

Question Title

* 4. Have you lost your home due to a fire within the last 3 years?

Question Title

* 5. Have you ever experienced domestic violence?

Question Title

* 6. Have you ever called a domestic violence agency for support? If yes, which agency? If no, why not?

Question Title

* 7. Have you experienced any of the following in a relationship? Choose all that apply.

Question Title

* 8. Have you ever experienced any of the following adverse childhood experiences (before the age of 18)? Choose all that apply. 

Question Title

* 9. Are you interested in volunteering, donating, or participating in events? Please check all that apply.

Question Title

* 10. As a thank you for completing this survey, Westside Domestic Violence Shelter has made limited gift bags for those interested. If you are interested in a gift bag or opportunities listed in the previous question, please provide your name, number & email to contact. (Optional). If you or someone you know is experiencing DV, please call/text our hotline (530) 865-4899.

0 of 10 answered
 

T