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Surveys
2017
April
D
Domestic Violence Anonymous Survey
Domestic Violence Anonymous Survey
0%
Questions marked with a
*
are required
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*
How old are you?
13-20
20-30
30-40
40-50
50-60
65+
*
What is your race/ ethnicity?
Black or African America
Hispanic
White
Asian
Native American
Pacific Islander
Other
*
Have you ever been directly involved in domestic violence?
Yes
No
*
Was the abuse reported?
Yes
No
Other
If not can you please list a reason why:
Did anyone else know about the abuse?
Yes
No
If your answer was yes, who?
Are you aware that there are different forms of abuse?
Yes
No
*
If you were not personally abused, do you know someone who was abused?
Yes
No
Do you know if they reported the abuse?
Yes
No
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