Empower Program
This section is to evaluate your overall experience with our Empower Program in general.
I am satisfied with my experience in the Empower Program this past month.
My casework meeting this month helped me reach my goals.
This past month, Empower Night was a place where I could heal and learn to walk in freedom.
The Empower Program provided the services I a wanted/needed this past month.
The Empower Program values align with my values.
I would recommend the Empower Program to someone else in my situation.
Please check ALL services you have participated in with Rescue Her this month:
Advocate Evaluation
This section is to evaluate your Empower Advocate.
I was satisfied with my Advocate this month.
I felt supported by my Advocate this month.
I felt understood by my Advocate this month.
I believe my Advocate upheld Empower Program values this month.
My time was well-spent with my Advocate this month.
Please note if there is anything additional you are needing from your Advocate.
Mentor Evaluation
This section is to evaluate your mentor.
I was satisfied with my mentor pairing this month.
I felt supported by my mentor this month.
I felt understood by my mentor this month.
I believe my mentor upheld Empower Program values this month.
I would recommend my mentor to someone else in my situation.
Please note if there is any additional information our staff should know regarding your mentor.
Are there any issues, concerns, or conflict you would like to see addressed?
Please provide a brief overview.
Any additional feedback you would like to provide (good, bad, or in-between).
Participation in Empower Program
This past month, I actively participated in the services offered by the Empower Program.
This past month, I actively worked towards my goals set during monthly casework meeting.
This past month, I upheld the Empower Program values. (Honor, Tenacity, Honesty, Forgiveness, Community, Independence, Restoration, Biblical Truth)
After this past month, I feel ready to "graduate" from the Empower Program.
What is one of the Empower Program values I want to focus on more?
Self Evaluation
It is normal to have a bad day, or a low period throughout the month. Please evaluate yourself based on the entirety of the month not a single event.
This month, I felt less isolated and more connected to others.
Because of the Empower Program, I have felt less overwhelmed when it comes to reaching my goals this month.
This month, I was able to regulate my emotions.
This month, I felt calm/peaceful more times than I felt anxious.
This month, I felt joyful/hopeful more times than I felt depressed.
After this month, I am closer to independence than I was last month.
After this month, I am proud of myself.
This survey is anonymous. If you would prefer we know your name, please type it below.
Thank you for your feedback!
If you would like to receive a $25 Amazon e-gift card for completing this survey, please take a screenshot of this page and send it to your Advocate. Please give us 1 week to send the gift card.
