3 minutes
The survey is usually open to people who have been sexually assaulted in the past 12 months.
What is your age?
What is your gender?
What is your race or ethnicity?
What is your sexual orientation?
What is your relationship status?
Have you ever experienced sexual violence?
If yes, please describe the nature of the sexual violence you experienced.
Have you ever been a victim of intimate partner violence?
If yes, please describe the nature of the intimate partner violence you experienced.
Have you ever been a victim of stalking?
If yes, please describe the nature of the stalking you experienced.
Have you ever been a victim of online harassment?
If yes, please describe the nature of the online harassment you experienced.
Describe any impact sexual violence had on your life?
Have you ever reported a sexual violence incident?