Section A: About your organisation

1. Please give your organisation's contact details:
* Name of organisation:
* Main contact:
Job title:
Address:
* Contact tel:
E-mail:
Website address:
2. How many staff does your organisation have?
Total number of staff:
Number of frontline service staff:
3. Please give a brief description of the main services your organisation provides:
4. Please specify which geographical areas of Nottinghamshire your service users come from:

Section B: Contact with domestic violence

1. Does your organisation come into contact with those experiencing domestic violence?

Women Children Men

2. Does your organisation provide information/support to those who have experienced/are experiencing domestic violence? For each of the following, please specify what information/support is provided.

Women:

Children:

Men:

3. Does your organisation refer women to any of the following services?

Nottinghamshire 24 hour domestic violence helpline National 24 hour helpline Domestic violence specialist services

Please specify, e.g. Local Women's Aid groups:

4. Does your organisation make referrals for children experiencing domestic violence to any of the following services?

Children Social Care (Social Services) Specialist domestic violence services (see above) Other services

Please specify which other services:

5. Does your organisation provide services to perpetrators of domestic violence?

Yes No

Please specify what services are offered:

Section C: Monitoring and training

1. Does your organisation keep a record of any data relating to domestic violence?

Yes No

2. Does your organisation have a domestic violence training strategy for staff?

Yes No

Please give details:

3. Please give details of domestic violence training undertaken by staff in your organisation since April 2005. If possible, we would like to know the date, title and provider of the training course, as well as the name and role of staff attending the course.

Other information

Please add any additional information you think appropriate:

Please give details of any other projects or initiatives you think we should contact for this study:

Many thanks for your time in contributing to this work.

Data Protection Act 1998

The personal information collected on this form will be processed on computer to provide and manage the information or service that you have requested. For further details regarding your privacy please see our Privacy Statement.