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 Thank you for your input. All information is confidential.

Domestic Violence Awareness Survey

What is your gender?

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What is your age?

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What is your race?

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What is your maritial status?

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What is the highest grade of school completed?

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What is your yearly household income?

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Do you currently know, or have you known someone who is or was a victim of domestic violence?

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Did you talk to the person about the domestic violence situation?

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If no, why not?

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What resources are available to domestic violence victims in your area?

Please indicate how much you agree or disagree with each following statement. Please pick only one response to each statement.

If someone is being abused, they have done something to cause it.

Select an option

If I know a friend, co-worker, or family member is a victim of domestic violence, I think I should mind my own business.

Select an option

I don't know what I can do to help prevent domestic violence in my neighborhood/community.

Select an option

Have you ever been a victim of domestic violence?

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