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2. Name (optional)
4. Email Address (optional)
6. Select your contact with the New Kent/Charles City Victim Witness Program*

   1. Person
   2. Phone
   3. Mail
   4. Email
8. How did you hear about the New Kent/Charles City Victim Witness Program?*

   1. Law enforcement
   2. Prosecutor
   3. Website
   4. Facebook
   5. Received a letter
   6. Other
10. How satisfied are you with your experience with the New Kent/Charles City Victim Witness Program?*

    1. Extremely satisfied
    2. Satisfied
    3. Dissatisfied
    4. Extremely dissatisfied
12. How helpful was the advocate who assisted you?*

    1. Extremely helpful
    2. Helpful
    3. Not helpful
    4. Extremely unhelpful
14. How likely are you to seek help from the New Kent/Charles City Victim Witness Program in the future?*

    1. Extremely likely
    2. Likely
    3. Not sure
    4. Unlikely
    5. Extremely unlikely
16. Additional comments
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18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

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