Thank you for filling out this survey:

Name:

1) How old are you?

Under 18 years old

Between 19 and 24 years old

Between 25 and 34 years old

Between 35 and 44 years old

More than 45 years old

2) How often do you visit my page?

Every Day

Once per week

Once per month

Once per year

3) Are you a survivor of an act of violence?

Spousal Abuse

Rape

Stalking

Other

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