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Phone: 540-483-5088
Hotline: 540-483-1234
Text: 540-329-3299 (M-F 12am-12am)
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Community Needs Assessment
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Family Resource Center Community Needs Assessment
Franklin County Family Resource Center
P. O. Box 188
Rocky Mount, VA 24151
Phone 540-483-5088
24 Hour Hotline 540-483-1234
Please take a moment to answer the following questions to assist us with our Community Needs Assessment.
Gender
Male
Female
N/A
Age Group
-- Select One --
15 - 17
18 - 25
26 - 39
40 - 54
55 - 69
70 - 99
Which Franklin County District do you live in?
-- Select One --
Boone
Blackwater
Blue Ridge
Gills Creek
Rocky Mount
Snow Creek
Union Hall
How did you hear of our services? (Check all that apply)
Phone
Internet
Law Enforcement
Hospital
Family/Friend
Church
PCS
STEP
Social Services
Doctor
Lawyer
Other
If Other, please list
Have you ever been in an abusive relationship?
Yes
No
If you have been in an abusive relationship, check all options that kept you from leaving the relationship.
Safety Plan
Food
Money
Housing
Health Care
Social Services
Counseling
School
Drug Rehab
Other
If you answered Other to the previous question, please list reason.
Have you ever known someone that was in an abusive relationship?
Yes
No
If you have known someone that was in an abusive relationship, check all options that kept them from leaving the relationship.
Safety Plan
Food
Money
Housing
Health Care
Social Services
Counseling
School
Drug Rehab
Other
If you answered Other to the previous question, please list reason.
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