1. What type of victimization(s) did you or your loved one experience? (Check all that apply.)

Adult victim of sexual assault
Adult survivor of incest or child abuse
Child victim of sexual assault
Child victim of physical sssault
Domestic violence
Assault/battery
Robbery
Survivor of homicide victim
Elder abuse

2. What service(s) did you receive? (Check all that apply.)

Telephone counseling
Face-to-face counseling
Support group counseling
Information and referral to other agencies whose services I needed
Personal advocacy (example: provide a letter of support, called an agency on my behalf)
Emergency financial assistance
Information on the criminal justice system
Court accompaniment (testimony, deposition, case management, etc.)

3. The Victim Advocate Counselor I spoke with addressed my questions and concerns.

Strongly agree Agree Disagree Strongly disagree

4. The Victim Advocate Counselor I spoke with showed concern for my well-being.

Strongly agree Agree Disagree Strongly disagree

5. I would use the services again or recommend a Victim Advocate to a friend who has been victim of a crime.

Strongly agree Agree Disagree Strongly disagree

6. If you received referral services from a victim advocate, were they redundant or repetitive?

Yes No

Can you provide an example?

7. Where you satisfied with the services you received overall? Please place comments in box below.