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Center for Survivors of Sexual Violence (CSSV): Advocacy Satisfaction Survey
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Center for Survivors of Sexual Violence (CSSV): Advocacy Satisfaction Survey
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Center for Survivors of Sexual Violence (CSSV): Advocacy Satisfaction Survey
What CSSV services did you receive? (Check all that apply)
Medical Advocacy
Legal Advocacy
Referral to Counseling
Support Groups
Supportive Listening
Shelter/Housing Connection
Please provide any comments on these services.
Overall, I feel the services I receive are helpful.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Why do you agree or disagree?
The most helpful part of CSSV services is:
Suggestions for improving CSSV services:
CSSV staff treat me with respect.
Strongly Agree
Agree
Don't Know
Disagree
Strongly Disagree
Why do you agree or disagree?
CSSV staff are caring and supportive.
Strongly Agree
Agree
Don't Know
Disagree
Strongly Disagree
Why do you agree or disagree?
Overall, I feel comfortable with CSSV staff.
Strongly Agree
Agree
Don't Know
Disagree
Strongly Disagree
Why do you agree or disagree?
If needed, CSSV staff help me create a safety plan for now and in the future.
Strongly Agree
Agree
Don't Know
Disagree
Strongly Disagree
N/A
Why do you agree or disagree?
I now have more strategies to enhance my safety.
Yes
No
I now have more knowledge of community resources available to me.
Yes
No
Additional comments or concerns:
Demographic Information
The following questions are optional and will help us know who is using our services so we can continue to improve our programs to meet the needs of all clients.
What ethnicity to you identify as?
What is your gender identity?
Female
Male
Transgender Male to Female
Transgender Female to Male
Gender Fluid
Non-Binary
An identity not listed: please specify below
Prefer not to disclose
If you checked "An identity not listed" above, please specify:
What is your age?
What is your sexual orientation?
Heterosexual/Straight
Lesbian
Queer
Bisexual
Gay
Questioning
Asexual
Pansexual
Same-gender loving
An identity not listed: please specify below
Prefer not to disclose
If you checked "An identity not listed" above, please specify: