Form Center

By signing in or creating an account, some fields will auto-populate with your information.

Victim Assistance Satisfaction Survey

  1. The Victim Survey is anonymous and the information you provide will help us to better serve the Salem Community.
  2. Please rate the services you received by selecting the appropriate number on the scale.

    1= Poor, 3= Average, 5= Excellent

  3. Did you find the staff to be helpful?*
  4. Was staff available when you needed assistance?*
  5. Did staff treat you with courtesy and respect?*
  6. Overall, how helpful was the program to you?*
  7. Did staff satisfactorily answer your questions?*
  8. Were you contacted in a timely fashion?*
  9. Please provide your comments on the following:
  10. Do you feel this is a valuable program for victims of crime?*
  11. Do you feel it is important that the program exists in the City of Salem?*
  12. Leave This Blank:

  13. This field is not part of the form submission.