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!

Ext. Quality Assurance Survey

Date:
Type of Survey:
I know more ways to plan for my safety:
How could we have helped you better plan for your safety:
I know more about community resources (resource outcomes):
How could we have helped you know more about community resources:
I know more about the justice/legal process and the options available to me overall:
How could we have helped you know more about the justice/legal process:
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:
Do you have any feedback you'd like to share: