Feedback Form

Feedback Form

Please complete this form to provide us with some feedback on your experience with SafeChoices.

What did SafeChoices assist you with?*

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Other

Preferred form of contact

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Other Contact

The intake/assessment process was smooth and easy to navigate.*

Strongly agree

Agree

Somewhat agree

Disagree

Strongly disagree

Please tell us what we could do better:

SafeChoices provided me with support I needed around family violence.*

Strongly agree

Agree

Somewhat agree

Disagree

Strongly disagree

Please tell us what we did well, what we could do better, or what would've improved your experience.*

SafeChoices made useful referrals for things they could not assist with.*

Strongly Agree

Agree

Somewhat Agree

Disagree

Strongly Disagree

Is there anything else you would like us to know?

Send me a copy of my responses

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