English Russian Spanish Ukrainian

SA Victim Survey

Who did you first tell about the assault?*
If you did not tell someone immediately following the assault, why not? (Check all that apply)*
How soon after the assault did you tell the person identified above?*
If you sought services from additional sources, please check ALL that apply:*
If you were examined by any medical provider, what services did you receive? Check ALL that apply.*
At the conclusion of the exam, how did you feel? Check ALL that apply.*
If you worked with a crisis center/shelter, what services did you receive? Check ALL that apply.*
At the conclusion of your contact with Law Enforcement, how did you feel? Check ALL that apply.*
Was the person who assaulted you: (Check ALL that apply)*