Rape Recovery Program Client Survey

We are honored to serve our community and want to ensure we are responding to the needs of sexual assault survivors. Please take a moment to complete this survey. We welcome your feedback and appreciate your time.

1. Where did you first have contact with a Rape Recovery Program staff member or volunteer?(Required)

If you answered, "Other" please use the space below to explain your answer.

2. Do you know the name of the Rape Recovery Program staff member or volunteer who spoke with you?(Required)

Name of Rape Recovery Program staff member or volunteer who assisted you.

3. Were they friendly/ courteous?(Required)

If you answered "No", please use this space to explain.

4. Did they listen to you and allow you to express your feelings?(Required)

If you answered "No", please use this space to explain.

5. Responding to the hospital – Was contact made within one hour of your request for service?(Required)

6. Did they offer you clothing to wear home?(Required)

7. Did they offer information and help filling out the Crime Victim Compensation Program form with you?(Required)

8. Which of the following free services were offered to you? Select all that apply.

Support Group

Individual counseling

Crisis hotline

9. Were you provided with a packet of Rape Crisis information?(Required)

10. Did they attempt to answer all your questions?(Required)

If you answered "No", please use this space to explain.

11. Over all, how satisfied were you with the services you received?(Required)

Please use this section to make additional comments or offer suggestions on how the Rape Recovery Program can respond to the needs of sexual assault survivors.

Name

First Last

Email(Required)

Age(Required)

Race(Required)

Gender(Required)

Rape Recovery Program Client Survey

You can make a difference.

You can make a difference.

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You Are Not Alone. Get Help Today!

You Are Not Alone.
Get Help Today!