Assault Survivors Survey

Question Title

* 1. I am a survivor of

Sexual Assault

Sexual Harassment

Inappropriate behavior or comments

Domestic Violence

Other (please specify)

Question Title

* 2. Someone else I know is a survivor of:

Sexual Assault

Sexual Harassment

Inappropriate behavior or comments

Domestic Violence

Other (please specify)

Question Title

* 3. This incident took place:

At my home

At the perpetrator's home

At someone else's home

In the workplace

Other (please specify)

Question Title

* 4. What action did you (or another survivor) take after this incident?

I contacted the police

I contacted my HR manager

I dealt directly to the perpetrator

I spoke with friends or family

I sought support from another community organization

I have not yet taken action

I would not feel safe taking any action

Other (please specify)

Question Title

* 5. I know the following about my perpetrator that may help identify them

First name

Last name

Phone number

Email address

Home address

Name of employer

Work address

Height

Hair color

Eye color

Licence plate

Facebook profile

Twitter profile

Instagram profile

Other (please specify)

Question Title

* 6. If there were other victims, how comfortable would you be speaking with them?

I would be comfortable speaking with other victims

I would not be comfortable at all speaking with other victims

I am not sure

Question Title

* 7. Would you be more likely to take action and report the incident if you knew there were others with similar experiences with the same perpetrator?

Yes

Not sure

Question Title

* 8. If you had a way to reach other survivors, without having to identify the perpetrator, would you be willing to try this?

Yes, I would give it a try

No, I would not feel safe doing this

I am not sure

Question Title

* 9. Would you be willing to make a post on social media in order to reach other survivors, if the post did not identify the perpetrator?

Yes, I would post on social media to reach other survivors

No, I would not be comfortable doing this

I am not sure

Question Title

* 1. I am a survivor of

Question Title

* 2. Someone else I know is a survivor of:

Question Title

* 3. This incident took place:

Question Title

* 4. What action did you (or another survivor) take after this incident?

Question Title

* 5. I know the following about my perpetrator that may help identify them

Question Title

* 6. If there were other victims, how comfortable would you be speaking with them?

Question Title

* 7. Would you be more likely to take action and report the incident if you knew there were others with similar experiences with the same perpetrator?

Question Title

* 8. If you had a way to reach other survivors, without having to identify the perpetrator, would you be willing to try this?

Question Title

* 9. Would you be willing to make a post on social media in order to reach other survivors, if the post did not identify the perpetrator?

Question Title

* 10. Please provide any further comments about your experiences, or suggestions on how to help survivors and prevent recurring incidents.