Empowerment and Satisfaction Questionnaire- Long Form (ESQ-LF)

 

As a client of our agency, you received services in response to a traumatic event(s).  In order to provide the best possible services, we would like to know how much our agency helped you to deal with that particular trauma.  This survey should take 5-15 minutes to complete. All responses are anonymous and confidential. 

CVC is committed to all of the victims that we serve. If at any time you do not feel that your Victim Advocate or Counselor are helping you to the best of their ability, please ask to speak to a supervisor or, if that is unsuccessful, to the Executive Director.

Strongly DisagreeSomewhat DisagreeNeutralSomewhat AgreeStrongly Agree
1. Staff respected my background (e.g. gender, race, culture, ethnicity, sexual orientation, disability, lifestyle, etc.).
2. Services were available at times that were good for me.
3. I was asked to participate in deciding what services I would receive.
4. I feel the staff heard me.
5. I got the kind of service I wanted.
6. Staff helped me believe that I could change and improve my life.
7. The services I received helped me deal more effectively with my problems.
8. Because of the services I received, I learned skills to help me better manage my life.
9. The services I received helped me identify a support system.
10. The services I received helped me become aware of how crisis and trauma affect my life.
11. The services I received helped me plan for my safety.
12. The staff informed me about Victims Rights.
13. The services I received helped me cope with my fear for my safety.
14. Because of the services I received, I know more about the options and choices available to me overall.
15. I would return to this agency if I needed victim services in the future.
16. I would recommend this agency to a friend in need of victim services.
17. In an overall, general sense, I am satisfied with the services I received.
18. Because of the services I received, I know about community resources that are available to me.