You recently received services from our program and we would like to know how you felt about your experience. Please select the appropriate response to each question below. Include additional comments in the last field, if needed

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* 1. Date of Service

Date

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* 2. Which service did you receive from Haven House?

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* 3. Because of the advocacy/support services I have received from this program so far, I know more ways to plan for my safety.

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* 4. Because of the advocacy/support services I have received from this program so far, I know more about community resources, including resources such as shelter, counseling, family court, police, legal services, etc.

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* 5. Did we treat you well?

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* 6. Did we help you?

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* 7. Additional comments