PEARL CRISIS CENTER
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Victim Services Survey
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Sexual Assault
Domestic Violence
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Victim Services Survey
If you are completing the survey for the first time, you will receive an electronic Amazon gift card.
Please note, if you submit your survey anonymously, you will not be eligible for the gift card.
OPTIONAL Contact Information:
Name
*
First
Last
Phone Number
*
Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Client Satisfaction Survey:
*
Indicates required field
1. - Was the Pearl Crisis Center staff knowledgeable in your area(s) of need?
*
Yes
No
If 'NO' please explain:
*
2. - Did the Pearl staff treat you with respect?
*
Yes
No
If 'NO', please explain:
*
3. - Did the staff at Pearl inform you of your confidentiality (Data Privacy) and mandated reporting requirements?
*
Yes
No
If 'NO', please explain:
*
4. - Do you feel that Pearl is a safe place to receive services?
*
Yes
No
If 'NO', please explain:
*
5. - What is something NEW you learned at Pearl?
*
6. - Were there any services you felt you needed that were not provided to you by Pearl?
*
Yes
No
If 'YES', please explain:
*
Other Comments:
*
Submit
About Us
Our Mission and Impact
Our Staff
Board of Directors
Our Supporters
Internship Program
Contact Us
Victim Services Survey
TADA Application
Sexual Assault
Domestic Violence
Relationship Assessment
Youth
Community Closet
Donate
Volunteer
>
Community Closet Volunteers
>
Community Closet Adult Application
Community Closet Youth Application
Español