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pdfOMB CONTROL NUMBER: 0701-IRCP
OMB EXPIRATION DATE: XX/XX/XXXX
AGENCY DISCLOSURE NOTICE
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reviewing the collection of information. Send comments regarding the burden estimate or
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Version 1.1 – Effective 7/18/2017
Victims
Victim/Survivor Awareness of Co-location Advocacy Services
By having access to this survey, we assume that you have sought advocacy services recently.
Broadly speaking, what issue are you trying to address?
o
o
o
o
o
o
Sexual assault
Sexual harassment
Domestic violence
Stalking
Cyber harassment
Other
What type of advocacy did you use?
o
o
o
o
o
o
o
Sexual Assault Response Coordinator
Sexual Assault Response Advocate
Domestic Abuse Victim Advocate
Sexual harassment
Religious Support Teams
Victim's Counsel
Something not listed here
Page 1 of 7
How long have you been physically assigned and located at this installation?
o Less than 6 month
o 6-12 months
o 1-2 years
o 2-4 years
o Over 4 years
If you needed to speak with a victim advocate for any reason, would you be more likely to seek
services if sexual harassment, sexual assault, and domestic violence advocacy services were
housed in a single physical location?
o Definitely yes
o Probably yes
o Might or might not
o Probably not
o Definitely not
Are the following services located in one location at your installation?
Sexual Assault Response Coordinator (SARC), Domestic Abuse Victim Advocate (DAVA),
Sexual Assault Victim Advocate (SA VA), Sexual Harassment, Victim Counsel (VC), Religious
Support Team
o No
o Maybe - I'm not sure
o Yes
Page 2 of 7
In seeking advocacy services, did you reach the correct advocate on the first try? Choose the
response that best fits your situation from your perspective.
o
Yes - I got the right advocate on the first try or I was immediately connected to the right
care advocate
o
No - I did not get the right advocate on the first try. I had to leave and come back another
day.
o
No - I did not get the right advocate on the first or second try. I had to leave and try again
in a different office. It took me a couple times to find the right person to help me.
o No - I was turned away for care and I did not try again.
If you were turned away for care, can you share a little about your experience? Do not use an
personally identifiable information such as names or locations.
________________________________________________________________
Which of the following support services were offered to you? Please select all that apply.
o
o
o
o
o
o
o
o
o
o
o
Behavioral Health
Chaplain/Spiritual Support
DoD Safe Helpline
Legal/Victims Counsel (VC)
Medical
Victim Advocate/Uniformed Victim Advocate
Rape Crisis Center or Domestic Abuse Crisis Center
Offer to communicate with your leadership
Support with legal proceedings or law enforcement interviews
Safety Planning
Other
If “other”, please describe what other service was offered to you.
________________________________________________________________
Page 3 of 7
How satisfied were you with your advocacy services?
Extremely
dissatisfied
Somewhat
dissatisfied
Neither
satisfied nor
dissatisfied
Somewhat
satisfied
Extremely
satisfied
Ease of
access to
advocates
o
o
o
o
o
Quality of
advocacy
services
o
o
o
o
o
Availability of
advocates
o
o
o
o
o
Page 4 of 7
To what extent do you agree with the following statements?
Strongly
disagree
Somewhat
disagree
Neither
agree nor
disagree
Somewhat
agree
Strongly
agree
My advocate
showed
sensitivity
and care
towards my
experience.
o
o
o
o
o
My advocate
built trust and
rapport with
me.
o
o
o
o
o
My advocate
validated my
experience.
o
o
o
o
o
My advocate
facilitated my
next steps in
the process
of helpseeking,
whether
officially
reporting or
not.
o
o
o
o
o
The physical
location of
my
advocate's
office made
coming to
them easy
(i.e., welladvertised
location,
easy to find,
discreet, etc.)
o
o
o
o
o
Page 5 of 7
How would you rate the quality of communication between you and your advocate?
o Terrible
o Poor
o Average
o Good
o Excellent
How many times did you have retell details of your experience to someone after you were
connected with an advocate? Please enter an estimate number.
________________________________________________________________
If you did have to share details of your experience multiple times, was it clearly explained to you
why you had to retell your experience to multiple people during the reporting process?
o No
o Somewhat
o Yes
o N/A; did not have to retell my experience to multiple people
Did connecting with a victim advocate reduce your stress around the event?
o No
o Somewhat
o Yes
Page 6 of 7
Based on your overall experience with either a single advocate or multiple advocates, would you
recommend others to seek advocacy services if needed?
o Strongly recommend
o Would recommend
o Unsure or ambivalent
o Would NOT recommend
o Would strongly NOT recommend
Is there something the DAF, your leadership, or advocates could have done to help you report
your experience sooner?
How much do you agree with the following statement?
The Department of the Air Force provides adequate support and resources to Airmen and
Space Professionals who have experienced any form of interpersonal violence or workplace
relation issues.
o Strongly disagree
o Somewhat disagree
o Neither agree nor disagree
o Somewhat agree
o Strongly agree
Page 7 of 7
File Type | application/pdf |
File Modified | 2022-08-23 |
File Created | 2022-07-07 |