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Victim Services Feedback Form
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This form has been modified since it was saved. Please review all fields before submitting.
Date:
*
Date:
Date form is being completed
Case #:
*
Please provide your case #.
Date of Incident:
*
Date of Incident:
Please provide the date on which your case occurred.
In an effort to provide better service to crime victims and witnesses, the Victim Services Unit would appreciate your assistance in completing this survey. Your responses are confidential.
Please rate your overall experience with the Police Department:
Poor
Fair
Good
Exceptional
Please rate your overall experience with the victim advocate:
Poor
Fair
Good
Exceptional
I received a Victim Rights and Assistance Brochure.
Yes
No
I understand the criminal justice system process as it relates to my case because of the information I received from the victim advocate.
Yes
No
Please indicate whether you agree or disagree with each statement below:
The victim advocate explained victims' rights to me.
Agree
Disagree
The victim advocate provided me with emotional support.
Agree
Disagree
I feel that I was treated with fairness, dignity, and respect.
Agree
Disagree
I received information to help me plan for my safety/Smart 911.
Agree
Disagree
N/A
I was provided information about the availability of community resources for emotional or financial assistance.
Agree
Disagree
N/A
I received information on how to sign up for VINE or I was registered with VINE (Victim Information and Notification Every Day).
Agree
Disagree
N/A
I received information about Crime Victim Compensation.
Agree
Disagree
N/A
My phone calls to the victim advocate were returned promptly.
Agree
Disagree
N/A
Any other comments on services provided by Victim Services or need for additional assistance:
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