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* 1. What is your gender identity? 

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* 2. Which of the following best describes your current relationship status?

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* 3. Which of the following best describes your experience of Intimate Partner Violence (IPV)? *IPV includes verbal, emotional, financial, spiritual, cultural, physical, sexual, and social abuse by a past or current intimate partner*

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* 4. Which of the following best describes your romantic partners?

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* 5. I would feel safe attending the following (check all that apply):

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* 6. What Type of Group interests you? (Select all that apply)

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* 7. Group service delivery during COVID-19 has been moved to virtual Zoom sessions. Are you interested in attending a virtual group?

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* 8. What days would you be able to attend a virtual group?

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* 9.  What time of day would you be able to attend a group?

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* 10. What barriers might get in the way of you being able to attend a virtual group? (Check all that apply)

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