Log Form Feedback Phase
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Log Form Feedback Phase - Seeking Survivor Feedback
We're survivor-led, and we're here to:
Provide survivors of sexual assault who don’t report a safe, anonymous platform to be heard and counted without pressure to report.
Understand the barriers survivors face to reporting and to seeking medical, mental health, or legal services.
We're seeking survivors’ feedback on the clarity and user experience of the log form to ensure it is survivor-friendly.
If you are a survivor, we would be grateful for your feedback.
Providing this feedback should take you about 10–15 minutes. We're only asking for a response in the feedback box at the bottom. No other responses are required.
We'll ask that you select ‘No’ to 4 questions to reveal the follow-up question about barrier(s) faced. This is for feedback purposes only. You can uncheck ‘No’ before submitting your feedback.
We're testing the usability of the form with 10-15 survivors to ensure it meets survivors’ needs.
All survivor feedback is welcome.
The feedback will be anonymous.
No sensitive survivor data will be collected.
Would you like to see our questions in advance?
Here’s a preview of the questions on the log form.
How long ago did it happen?
Did you know your perpetrator?
Have you reported what happened?
Have you received medical care?
Have you received mental health support?
Have you received legal help?
If you answer ‘No’ to deciding not to report or to seek medical, mental health, or legal support, 1 follow-up question will appear for each ‘No’ answer asking you to select any barrier(s) you faced. These follow-up questions will be required to submit your log.
9 demographic questions will be optional, with a choice to select ‘Prefer Not to Say.’
Gender
Current age
Race
Sexual orientation
Student status
School type (ungrad, grad, etc.)
School size (number of students)
Region in United States
Disability status
There’s one final ‘required’ question.
Do you consent to share your optional demographic answers? (‘Yes’ or ‘No’)
We’ll publish the results of this feedback phase here.
With this feedback, we’ll improve the log form and then pilot it with the LGBTQ+ community in Chicagoland.
We will build a model that can be replicated.
We’ll partner with other organizations serving marginalized survivors, giving them free access to their aggregated data on the barriers survivors face to reporting and to seeking medical, mental health, or legal services, and consented demographic information.
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