Annual Client Consult Survey Sep 24, 2015 1. What age are you? (please select) 18-25 26-35 36-45 46-55 56-65 66+ 2. What gender do you recognise as? (please select) Female Male Other 3. Which service are you currently using? (please select) Family Violence Sexual Assault SABTS Unknown/Other 4. How many sessions have you had to date? (please select) 0-2 2-4 4-6 6-8 8 or more 5. How satisfied are you with the help you received so far? (please select) Very satisfied Mostly satisfied Mildly dissatisfied Quite dissatisfied 6. Thinking about the goals you hope to achieve by using this service, please rate where you believe you are in reaching such goals. Goals not reached Part way to reaching goals Have nearly reached goals Goals reached 7. Do you think that all your needs were met by the service? 8. Do you feel your life has improved since your involvement at Centre Against Violence? (please select) Very much Yes A little No Please tell us how: 9. Select as many of the following you feel you have achieved or almost achieved as a result of using this service: Less anxiety Improved wellbeing Increased sense of safety Improved self esteem Better sleep Increased trust Improved sense of control Improved mental health Improved relationships Other 10. What would be your most positive experience during your time with us? 11. Where there any negative experiences? 12. While you were receiving services, do you think your: cultural, spiritual, ability/disability and/or identity were respected? How can we improve this? 13. Are there any other comments or suggestions you would like to make related to your experience of our services? 14. What could CAV staff members do to lift the value of the service for you?
