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| My name is Natasha Mendoza, a student from Woburn Collegiate Institute and I am conducting a survey to gather information on child abuse and domestic violence. This survey will take approximately 5 minutes to compete. Please answer each question honestly. Data from this questionnaire will be anonymous and kept confidential. Thank you in advance. |
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| * Have you or someone you know experienced family violence? |
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| * How often have you or someone you know experienced family violence? |
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| * Was the abuser also abused as a child? |
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| Violence at home has affected you or someone you know in the following areas: (Select all that apply) |
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| Have you or someone you know ever had suicidal thoughts because of family violence? |
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| Rank what order you have or would be more exposed to violence, where "1" indicates the most. |
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| School |
| | | Home |
| | | Streets |
| | | Work |
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| Which of the following have you or someone you know participated in as a result of family violence? Check all that apply. |
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