Trafficking & Exploitation Screening Assessment (TESA) + Survey

Thank you for your interest in completing the Trafficking & Exploitation Screening Assessment and survey for Scarlet Road and our corresponding research partners.

The purpose of this survey is to evaluate if people clearly understand the questions asked on the TESA screening tool.

Survey Consent

I give my consent to share this data with a review panel that will review survey findings and the effectiveness of this tool. I understand that my personal information will not be shared and I will not receive follow-up communication unless I have requested it.

Yes	No (if no, the survey will end)

Trafficking & Exploitation Screening Assessment (TESA) + Survey

The below questions are to help us understand, from your point of view, what care would be most helpful. Please answer as honestly as you are comfortable. Answering these questions will NOT negatively impact your access to support.

Note that required questions are marked with a red asterisk (*)

Additional Information

Some of my experiences feel similar to the descriptions above but I am not sure if it fits.

Yes

No

Not Applicable

First Name

Last Name

Date of Birth

Preferred Language

Advocate Support

I would like to talk with an advocate. I give permission for an advocate to follow up with me.

Yes

No

Not Applicable

Contact information for advocate follow up (please include if you want to be contacted)

Safe Phone Number

Email Address

Contact me another way (name of your advocate, provider, etc.)

Is there anything else you would like us to know (examples could include relocation information, safety concerns, etc.)?

Demographic Information

Please help us understand your lived experiences.

Age

Gender Identity

Sexual Orientation

Where did you see the flier for this survey?

If other, where did you see this survey?

On behalf of Scarlet Road, we want to thank you for completing the TESA survey. Your feedback is vital for ensuring the effectiveness of the tool.

If you would like to be contacted by a Scarlet Road advocate for any reason, an advocate will be in touch within 72 hours.

Survey Gift Card!

**THIS SECTION IS NOT REQUIRED**

If you would like to receive a $5 compensation gift card in the mail for completing the survey, please enter a name and mailing address here. Your mailing information will not be associated with the data collected in this tool or survey.

Mailing Name

Mailing Address

Mailing City

Mailing State

Mailing Zip Code

Trafficking & Exploitation Screening Assessment (TESA) + Survey

Trafficking & Exploitation Screening Assessment (TESA) + Survey

Survey Questions

Demographic Information