Sexual Assault Survivor Experience Survey
This survey will take about 15 - 20 minutes. This survey is completely voluntary. Your responses are anonymous and will not be connected with any personally identifying information. We are students at East Tennessee State University working on a project with Collective Impact for Emotional and Sexual Health. Your responses will help us develop programming to better serve survivors of sexual assault. Thank you for taking time to contribute to this project.
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What is your gender identity?
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Gender identity self- description (If your gender was not listed above)
What is your age ?
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Color/Race/Ethnic identity [Check all that apply]
Color/Race/Ethnic identity self-description (if it was not included in the previous question)
If you identify with a particular religion, please list it here.
Sexual assault is any sexual contact without consent. This can range from sexual touch to rape. Have you ever been sexually assaulted?
If the answer is no please submit the form. Thank you for participating in the survey there is no need to answer the following questions.
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Have you ever been sexually assaulted in [select all that apply]
Approximately what year/s did the sexual assault/s happen ?
At or around the time the assault occurred, did you tell anybody?
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Why did you choose to tell or not tell?
If you did tell someone, who did you tell?
Was telling someone helpful?
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