Email:

Phone Number:

Thank you for completing this short survey on your experience working with Safe Voices! Please answer these questions to the best of your ability and help us improve the quality of our services. Your individual responses will remain anonymous and will be used to help us evaluate our programming. Please select the program in which you recently received services. If you aren't sure which option applies to you, please ask your advocate or refer to the following: DV-CPS Liaison - receiving help from an advocate on your safety needs around an open child protective matter EPIC - receiving help from an advocate in connection to a recent experience with law enforcement Hotline - calling the hotline or receiving a call back from the hotline Individual Advocacy - working one on one with an advocate outside of the hotline, i.e. at an outreach location, at the hospital, etc. Legal Program - receiving help with a protection order or other civil matter, or a criminal matter, preparing court documents, court accompaniment, etc. Residential Services - receiving services within the shelter, hotel, housing navigation services, or transitional housing services program Support/Educational Group - Weekly Support Group Thank you for your time!

استطلاع رأي العميل

Date:
نوع الاستطلاع:
أنا على دراية بطرق أخرى للحفاظ على سلامتي:
كيف يمكننا مساعدتك في الحفاظ على سلامتك بشكل أفضل:
أعرف المزيد عن الموارد المجتمعية:
كيف يمكننا مساعدتك في معرفة المزيد عن الموارد المجتمعية:
6. أعرف المزيد عن العدالة / الإجراءات القانونية والخيارات المتاحة لي بشك:
أعرف المزيد عن العدالة / الإجراءات القانونية والخيارات المتاحة لي بشكل عام:
My stay at the Safe House was adequate:
How could we have made your stay better:
I had/have a relapse in my safety and prevention plan:
What did you think caused the relapse:
Do you feel safer after contact with the Safe Voices:
What would have made you feel safer:
هل لديك أي ملاحظات تود مشاركتها: