Service Provider (Advocate): Who was your Advocate?
Please indicate, in your experience, the degree to which your advocate:
Demographic Information (For statistical Purposes Only): Age: Gender: Ethnicity:
Relation to the University: Student Faculty Staff Other
Marital Status Single Married Divorced Widowed Domestic Partnership
Information:
How did you first learn about our services? Beacon Ad Flyer Presentation Information Table Student Handbook Website Referral (Please Specify)
How did you contact the Victim Advocacy Center? Office Phone Walk-in 24 Hr. Support and Information Line (305-348-2000) Referral
What caused you to seek our services? Domestic/Dating Violence Sexual Assault Stalking Assault and Battery Sexual Harassment Murder Survivor Hate Crime Other (Please Specify)