Annual Client Consult Survey 2021
Date *
What age bracket are you in?
Clear selection
Are you of Aboriginal or Torres Strait Islander decent?
Clear selection
How do you describe your cultural identity? (place of birth, language, ethnicity)
Do you identify as LGBTIQA+?
Clear selection
If Yes, What is your gender identity?
Which site did you visit?
Clear selection
Which service are you currently using?
Clear selection
How many sessions have you had to date?
Clear selection
How satisfied are you with the help you have received so far?
Clear selection
Thinking about the goals you hope to achieve by using this service, please rate where you believe you are in reaching such goals.
Clear selection
Do you think that all your needs were met by the service?
Do you feel your life has improved since your involvement at Centre Against Violence? (please select)
Clear selection
Please tell us how:
Select as many of the following you feel you have achieved or almost achieved as a result of using this service:
What would be your most positive experience during your time with us?
Were there any negative experiences?
While you were receiving services, do you think your: cultural, religious, faith, spiritual, ability/disability and/or identity were respected? How can we improve this?
What could CAV staff members do to lift the value of the service for you?
Has your safety been effected by the restrictions in place due to COVID 19? If yes, how?
CAV has provided services using phones and media such as face time and teams. Tell us what you think of that?
Are there any other comments or suggestions you would like to make related to your experience of our services?
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy