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SASS Evaluation Form

Service User Evaluation

Your answers will help us improve our services but also assist us in demonstrating to funders the importance of the work that we do in supporting our clients.  Your answers are completely confidential.  No one in our organisation is going to know how you answered any of these questions.  No individual could possibly be identified.  Please respond to as many questions as you feel comfortable with.  If you're not sure of an answer, give us your best guess.
1.What gender do you identify as? (please tick box)
2.What is your age group? (please tick)
3.How did you hear about SECASA? 
4.How did you receive a service from SECASA?
5.Which SECASA site did you attend most recently? (please tick one box only)
6.Are you a victim / survivor of any of the following ( please tick any relevant boxes)
7.Have you attended a sexual assault or family violence counselling service before?
8.Why did you choose SECASA as the service to seek help? (Please tick any relevant boxes)
9.How emotionally safe do you feel at SECASA now? Tick one box only.
10.How satisfied are you with the support / services that SECASA provided?
11.If you felt unsatisfied about any part of our service, what could we do to improve the service for you?
12.In which of the following ways have the services provided by SECASA helped you, even if it was just a little bit? You may tick as many boxes as appropriate.
13.As a result of the support / services provided by SECASA do you feel more confident about managing your life? Please tick.
14.To what extent do you think that the support / services provided to you by SECASA have helped you deal with the trauma or incident that brought you to seek SECASA’s assistance? Please tick one box only.
15.Have the ways that you view or think about sexual assault or family violence changed and are a result of the support you have received from SECASA?
16.If SECASA or the counsellors have helped you, we would really appreciate it if you could write in the space below how it has helped you.
17.It would be really helpful to SECASA if you could provide suggestions about ways to improve the service.