2 minutes
To be eligible for the survey, you must have been, a victim of rape or sexual assault, 18 years of age or older at the time of the incident. If you do not meet these criteria, you are not eligible for the survey.
What is your relationship to the person who raped or sexually assaulted you?
How old were you when you were first raped or sexually assaulted?
How many times have you been raped or sexually assaulted?
Where did the rape or sexual assault occur?
Was the person who raped or sexually assaulted you under the influence of drugs or alcohol at the time of the incident?
Did you know the person who raped or sexually assaulted you before the incident?
Were you physically injured as a result of the rape or sexual assault?
Did you receive any medical treatment as a result of the rape or sexual assault?
Did you report the rape or sexual assault to law enforcement?
If you did not report the rape or sexual assault to law enforcement, why not?
Have you ever been contacted by law enforcement about the rape or sexual assault?
Have you ever been contacted by the person who raped or sexually assaulted you?
Have you ever been contacted by anyone else about the rape or sexual assault?
Have you ever sought therapy or counseling as a result of the rape or sexual assault?
Has the rape or sexual assault had any impact on your relationships?
Has the rape or sexual assault had any impact on your work or school?
Has the rape or sexual assault had any impact on your mental health?