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

   1= Poor, 3= Average, 5= Excellent

6. Did you find the staff to be helpful?*

   1. 1
   2. 2
   3. 3
   4. 4
   5. 5
7. Was staff available when you needed assistance?*

   1. 1
   2. 2
   3. 3
   4. 4
   5. 5
9. Did staff treat you with courtesy and respect?*

   1. 1
   2. 2
   3. 3
   4. 4
   5. 5
10. Overall, how helpful was the program to you?*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
12. Did staff satisfactorily answer your questions?*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
13. Were you contacted in a timely fashion?*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
15. Please provide your comments on the following:
17. Ways you feel we could improve.
19. How did you learn about the program?
21. Please provide any comments that may be helpful to us in assisting future victims.
23. Was there anything about the service that was especially helpful to you? If so, please explain.
25. Do you feel this is a valuable program for victims of crime?*

    1. Yes
    2. No
27. Do you feel it is important that the program exists in the City of Salem?*

    1. Yes
    2. No
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29. 1. Receive an email copy of this form.
30. Email address

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31. Submit

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