Sexual Harassment Support
Support and information for anyone who has experienced sexual harassment.
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 Email:
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Location:
Age:
*
 Gender:
 Female
 Male
Did you have any difficulty finding a supportive counselor or therapist?
1.  
I had no trouble finding a supportive counselor/therapist

Some of the counselors/therapists were not supportive, but I
eventually found one that was supportive.
=>How many did you have to talk to before you found one
who was supportive?
<= Enter the #  
I was not able to find a supportive counselor.
Did you talk to female or male counselors/therapists, or both?
2.  
Female

Male
Both male and female
=>  If both, did you notice a difference between the two, such as
females being more or less supportive, or understanding, then
the males?
No difference
Yes, there was a difference.
=>  If yes, please explain:
3.  
 Do you feel that the counselors/therapists  you talked to understood what you
are/were going through, or that they understand sexual harassment and the
common dynamics and effects?
No   =>  What was their perspective?  Explain
below:
Yes
4.  
To the best of your knowledge, did your therapist/counselor maintain
confidentiality regarding your case or health care informaiton?  (For example,
did they share your information with other therapists, or with anyone
associated with your sexual   harassment situation without your consent?)
To the best of my knowledge, there were no confidentiality violations
with my health care information
My therapist/counselor did not maintain confidentiality with my case of
information
=> How was confidentiality violated?
5.
 Is there anything else you would like to share about your experience with
counselors or therapists as you tried to come to terms with the harassment
and its effects?
Thanks for sharing your insights!   Please submit only once.  If you have
any difficulty with this form, please email us at
survey2@sexualharassmentsupport.org  (Please indicate that it is the
Health Care Survey you are having trouble with.)
Please complete this brief survey that explore the health care response to sexual harassment
victims.  All of your answers will be kept completely confidential.   

This survey is only for sexual harassment or stalking victims who sought counseling or therapy to
come to terms with what has happened to them and the effects.

You are not obligated to answer any of the questions.  If you are unsure of how to answer one, just
skip it and move to the next.

Please check that the survey has loaded completely.  There should be 5 questions. You may have to
use Refresh at the top of your browser. If you prefer, we can email you a copy of the survey for you
to fill out and email back to us.

For questions, or to be emailed a survey, contact us at survey2@sexualharassmentsupport.org
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Mini-Survey:  Health Care Response to Sexual Harassment