VIP Survey 2024

This survey is required to receive credit and your certificate for attending the victim impact panel. Survey must be complete by the Wednesday after the panel you've attended in order to receive your certificate. Failure to complete this survey will result in an incompletion and you will have to reattend the next panel.

Please answer the following questions in order to receive your VIP certificate. If you don't remember exact names, dates, etc., just answer the questions as best as you can.

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* 1. First and Last Name

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* 2. Date of Birth

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* 3. Email Address (email address will be used for certificate only)

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* 4. Who ordered/referred you to attend this presentation?

Waukesha County Circuit Court

Judge outside of Waukesha County

Addiction Resource Council (ARC)/Driver Safety Plan

WCS

Other (please specify)

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* 5. Gender

Male

Female

Transgender

I prefer not to answer

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* 6. Age

16-24

25-34

35-44

45-55

56+

I prefer not to answer

Please finish the following statements:

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* 7. Wisconsin impaired driving laws are:

Too lenient

Adequate

Too tough

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* 8. Please elaborate on your answer from question 7:

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* 9. The times I have considered that I could have caused injury/death while driving impaired were:

Frequent

Never

Sometimes

Please answer the following questions to the best of your ability. If you don't remember exact names, dates, etc., just answer the questions as best as you can. (The following 6 questions must be answered in order to receive your VIP certificate)

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* 10. What was the name (first name only) of the first presenter?

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* 11. How was the first presenter's life impacted by an impaired driver?

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* 12. What was the name (first name only) of the second presenter?

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* 13. How was the second presenter impacted by an impaired driver?

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* 14. Describe what impact this presentation has had on your opinion about driving impaired?

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* 15. The speakers tonight volunteered their time to tell their story. In a few sentences, please describe what impact their presentations had on you personally?

Thank you for your time and attention. Your VIP certificate will be emailed to you within the next week. If you have any questions you can contact the Addiction Resource Council at frontdesk@arcouncil.net.