This survey will only take 5 minutes of your time.

TOWARDS A SAFE PLACE - LGBTIQ DV AWARENESS SURVEY

Thank you for agreeing to take part in the Catalyst Foundation survey on Domestic Violence Awareness within the LGBTIQ community.  This survey is part of and will help shape our project which will develop educational resources on Domestic Violence and the reporting of Domestic Violence specifically within the LGBTIQ communities.

This project has been funded by the SA Attorney General’s Crime Prevention Grants; our project partners include Uniting Communities Adelaide Bfriend Project and Pride in the South Group.

The contact person for this project is Paul Stone and Paul can be contacted on 8168 8776 or paul@catalystfoundation.com.au

Should this survey raise any personal issues for you we recommend you seek an appropriate counsellor or phone service with whom you can speak to and

Suggest the following services:

QLife – National telephone and web counselling service for lesbian, gay, bisexual, trans and intersex (LGBTI) people, families and friends.3pm to midnight, 1800 184 527 or www.qlife.org.au

1800RESPECT (1800 737 732) - Confidential information, counselling and support service

Open 24 hours to support people impacted by sexual assault, domestic or family violence and abuse.

DV Helpline - Counselling for victims of domestic violence and their concerned friends and counselling for people who commit domestic violence.  1800 800 098 - 24 hour line

South Australian Police – To report Domestic Violence or in an emergency phone 000, for information regarding SAPOL & DV phone 131 444 or contact your local area station.

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* 1. How do you identify your gender?

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* 2. Have you ever identified as Transgender?

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* 3. Were you born with an intersex variation?

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* 4. Do you identify as part of the LGBTIQ community?

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* 5. If you have answered yes to the above question, how do you identify?

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* 6. What is your age

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* 7. What is your cultural background?

  Yes No
Are you from an aboriginal or Torres Strait Island Background
Are you from a Culturally & Linguistically Diverse background

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* 8. What is your postcode?

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* 9. Which of the following would you consider to be Domestic Violence?

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* 10. Which of the following instances would you consider to be Domestic Violence?

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* 11. Have you ever experienced Domestic Violence?

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* 12. Have you ever reported Domestic Violence?

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* 13. Following on our previous question, on a scale of 1-5 how well were you supported? 1 being not supported and 5 being completely supported

  1 2 3 4 5
My experience was

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* 14. If you needed support for Domestic Violence which would you approach or feel would be appropriate for an LGBTIQ person to contact?

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* 15. Contact Information (optional). If you would like to take part in a focus group or a community consultation group, please leave your contact details below  or contact Paul at paul@catalystfoundation.com.au or 8168 8776.

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