2. Your responses will assist in providing grant funds necessary for the Victim Advocate Program.
   Please answer all of the questions.
6. What type of victimization(s) did you or a loved one experience?
8. How did you find out about the Daytona Beach Police Department Victim Advocate Program?

   1. Direct contact from the Program
   2. Police Officer
   3. Referral from another agency
   4. Website
   5. Other
9. What service(s) did you receive? (Indicate all that apply)

   1. Information - Criminal Justice System
   2. Information/Assistance - Injuctions for Protection (Restraining Order)
   3. Information - Victim Compensation
   4. Information - Victim Rights
   5. Information - Your Case
   6. In-Person Contact
   7. Personal Advocacy
   8. Referral(s) to other agencies for services
   9. Telephone Contact
   10. Other
11. Would you use the services of the Daytona Beach Victim Advocate Program again, if needed, or recommend the program to a friend?

    1. Yes
    2. No
13. Additional Comments
15. Would you like to be contacted about your responses?

    1. Yes
    2. No
17. If yes, please provide your contact information.
19. Name
21. Address
23. Phone #
25. Email Address
27. Thank You for completing this survey
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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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