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!

Sondaj Kliyan

Date:
Tip Sondaj:
Mwen konn plizyè fason pou m rete an sekirite:
Kòman nou kapab ede w rete an sekirite?:
Mwen konnen plis sou resous kominotè yo:
Kòman nou kapab ede w konnen plis sou resous kominotè yo?
Mwen konnen plis sou pwosesis Jidisyè/Jiridik yo ak opsyon yo souvan ofri m yo:
Kòman nou kapab ede w konnen plis sou pwosesis Jidisyè/Jiridik yo?
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:
Èske ou gen kòmante ou t ap renmen pataje ak nou?