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WA Sexual Assault Services Feedback Form
What type(s) of support did you use? Check all that apply
What type(s) of support did you use? Check all that apply
Emotional
Protection Order
Crime Victim Compensation
Legal Information & Assistance
Medical
Other (please specify)
Other
How long have you been working with us?
Less than 1 month
2-6 months
6-12 months
1+ years
Based on the services you have received, do you feel that you:
Yes
No
I know more ways to plan for my safety
Yes
No
I know more about community safety resources
Yes
No
What services have been most helpful to you, and why?
How do you feel about the support we have offered you?
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
The staff were respectful
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
The staff were caring
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
The staff were supportive
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
The staff were knowledgeable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
I was comfortable with staff's level of ability
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
I am more informed about my options
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
I am more informed about my legal rights and options
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
The referrals the staff offered were helpful
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
I feel comfortable using ATVP's services in the future
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
I would refer ATVP to others
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
Were there problems with the services you received, or were there services you needed that we were not able to provide? If so, please explain
Is there anything else you would like us to know about our services
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