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RE: Survivor Evaluation of Advocacy Services Form


Chronological Thread 
  • From: "LaDue, Lee E." <>
  • To: Juliette Grimmett <>, "" <>, "" <>
  • Subject: RE: Survivor Evaluation of Advocacy Services Form
  • Date: Wed, 1 Jun 2016 14:37:11 +0000
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Here’s one we send out via survey monkey.  I think it really depends on what you are wanting feedback on in terms of your services .

 

 

Client Satisfaction Survey

1. SCSU Women's Center Client Satisfaction Survey

We recognize that listening to the experiences of our clients is one of the most important things we can do.

The Women’s Center is interested in your feelings and opinions in regard to the services you have received from our staff. By requesting information from the people we serve, we can continue to enhance our services and improve the campus climate for our students.

Your name will remain anonymous.

Thank you for taking the time to complete this survey.

Top of Form

* 1. The Women's Center Advocate I spoke with created a comfortable and open atmosphere for me to talk about my situation.

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Applicable

Please tell us more about your experience.

* 2. The Advocate at the Women's Center was sensitive to my individual needs based on my ethnic, cultural, religious, and personal values.

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Applicable

Please tell us more about your experience.

* 3. The Women's Center Advocate I spoke with helped me explore other sources of support and made appropriate referrals.

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Applicable

Please tell us more about your experience.

* 4. The Advocate followed through on items mutually agreed upon in a timely manner.

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Applicable

Please tell us more about your experience.

* 5. The Advocate discussed confidentiality and informed consent with me.

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Applicable

Please tell us more about your experience.

* 6. The Advocate was knowledgeable about the issues that brought me to the Women's Center.

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Applicable

Please tell us more about your experience.

* 7. The Advocate clearly explained the available options to me according to my needs and helped me make informed choices about my situation.

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Applicable

Please tell us more about your experience.

* 8. Services at the Women's Center have assisted me in evaluating my educational goals and what I need to do for academic success.

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Applicable

Please tell us more about your experience.

* 9. The information given to me by the Women's Center Advocate helped me to better understand my options regarding the criminal justice system and the student code of conduct process as it relates to my situation.

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Applicable

Please tell us more about your experience.

* 10. How would you rate the Women's Center advocacy services overall?

Excellent

Good

Okay

Poor

Not Applicable

Other(Please Specify Below)

Comments and Suggestions:

Done

Bottom of Form

 

Lee Etta LaDue

Gender Violence Prevention Coordinator

Women's Center

720 4th Ave. S.

St. Cloud, MN 56301

320-308-3995

 

From: [mailto:] On Behalf Of Juliette Grimmett
Sent: Tuesday, May 31, 2016 9:46 PM
To: ;
Subject: Survivor Evaluation of Advocacy Services Form

 

Hey folks -

Does anyone have an evaluation you provide to survivors on campus regarding the advocacy services they received?  Or something similar?  If so, I'd love to see it - thank you!


--

Peace,

Juliette Grimmett, MPH
Chrysalis Network, Founder
CORE Constructs Consulting Developer, Culture of Respect

(919) 624-9575
www.chrysalisnetwork.com 

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