Consultant Feedback Form

OMB Control Number: 0970-0519
Expiration Date: 10/31/2021

CONSULTANT
FEEDBACK
Form

In order to help the National Human Trafficking Training and Technical Assistance Center (NHTTAC) better serve the field, we
are reaching out to obtain your feedback. We will protect the privacy of your information in accordance with the Federal Privacy
Act, and we will protect the confidentiality of your responses using procedures we have in place, including reporting all
information in aggregate to avoid identifying information. Only members of the NHTTAC Evaluation Team have access to
information that could identify respondents. If you have any questions about this survey or the evaluation, please contact
[email protected].
TRAINING/TECHNICAL ASSISTANCE (T/TA):
DATE(S):
NHTTAC COORDINATOR:

Please provide the information below to create an anonymous ID:

____________

____________

______________

Birth Month

First letter of first name

First letter of your middle name

(insert just the month

(example: S for Sara)

(example: M for Maria)

for your date of birth:
08 for August)

Please indicate the number that best represents your rating for each of the following questions.
1.

2.

How satisfied were you with the overall quality of the support you received from NHTTAC staff to complete this T/TA?
1

2

3

4

Very Dissatisfied

Dissatisfied

Satisfied

Very Satisfied

How satisfied were you with your overall experience with NHTTAC staff?
1

2

3

4

Very Dissatisfied

Dissatisfied

Satisfied

Very Satisfied

Please indicate the extent to which you agree or disagree with the following statements:

OVERALL T/TA
3.
4.
5.
6.
7.
8.

NHTTAC was detail oriented and thorough in the planning of the
T/TA.
NHTTAC was responsive to my questions and needs.
Discussions with NHTTAC helped me to identify critical issues
and understand the needs of participants prior to the T/TA.
NHTTAC provided me with the necessary information and
resources to help me adequately prepare for the T/TA.
The information developed or provided in the T/TA was based on
current evidence-based research or promising practices.
The time allotted was adequate for the scope of material covered.

Strongly
Disagree

Disagree

Agree

Strongly
Agree

Not
Applicable

1

2

3

4

NA

1

2

3

4

NA

1

2

3

4

NA

1

2

3

4

NA

1

2

3

4

NA

1

2

3

4

NA

Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The estimated average time to complete this form is 5 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.

OMB Control Number: 0970-0519
Expiration Date: 10/31/2021

CONSULTANT
FEEDBACK
Form
9.

The information [developed for the T/TA] [provided to the
participants] was survivor informed.
10. The T/TA was grounded in a multidisciplinary approach to
addressing human trafficking.
11. The T/TA reflected a public health approach to addressing human
trafficking.
12. The T/TA was trauma informed.

1

2

3

4

NA

1

2

3

4

NA

1

2

3

4

NA

1

2

3

4

NA

13. What obstacles or challenges, if any, did you encounter in the planning or delivery of this T/TA?

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
14. In what language was the training delivered?

□ English □ Spanish

15. How prepared did you feel for the delivery of the training?
1

2

3

4

Not At All Prepared

Somewhat Prepared

Mostly Prepared

Very Prepared

Please indicate the extent to which you agree or disagree with the following statements:

PROFESSIONAL DEVELOPMENT AND EXPERTISE

Strongly
Disagree

Disagree

Agree

Strongly
Agree

Not
Applicable

16. NHTTAC respected my perspective about
17. This was an appropriate outlet for using my skill sets and
knowledge.
18. Participating in the T/TA as a consultant enhanced my
communication skills.
19. Participating in the T/TA strengthened my confidence to consult in
future T/TA events.
20. As a consultant for NHTTAC, I have improved my leadership
competencies.
21. As a consultant for NHTTAC, I have more opportunities to
collaborate with other professionals in the field.
22. Overall, consulting for the T/TA contributed to my professional
development.

1

2

3

4

NA

1

2

3

4

NA

1

2

3

4

NA

1

2

3

4

NA

1

2

3

4

NA

1

2

3

4

NA

1

2

3

4

NA

23. Would you recommend others to be a consultant for NHTTAC?

□ Yes □ No

24. Would you recommend NHTTAC to others who need T/TA?

□ Yes □ No

25. Do you have any other comments or suggestions about how to improve the NHTTAC’s consultant network and/or NHTTAC
consulting experience??

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The estimated average time to complete this form is 5 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.

OMB Control Number: 0970-0519
Expiration Date: 10/31/2021

CONSULTANT
FEEDBACK
Form

26. What is your NHTTAC consultant category?

□ Survivor Impact □ Training/Technical Assistance (T/TA) Expert

27. Which of the following best describes the organization in which you work? (Mark all that apply.)
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force
Federal government
Faith-based organization
State and local government
Nonprofit/Community-based organization
OTIP grantee

Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Academic institution
Other (please specify):
______________________________

28. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes
□ No
□ N/A
29. Which of the following best describes your professional capacity or types of services you provide? (Mark all that apply.)





Behavioral health professional (e.g., psychologist,
psychiatrist, mental health/substance use counselor)
Child welfare (e.g., state agency staff, child welfare
contractor, nonprofit personnel)
Corrections-based services (e.g., parole, probation)
Criminal justice (e.g., law enforcement, prosecutor,
probation, court, forensic interviewer)
Educator (e.g., teacher, professor, school
administrator)
Health care (e.g., physician, physician assistant,
nurse practitioner, dentist, nurse, pharmacist)
Housing (e.g., case worker, shelter director, public
housing authority agencies)














Legal (e.g., immigration, civil and/or rights-based
attorney and/or paralegal, clinic)
Public health (e.g., licensure board, health
department staff, health care executive, community
health workers)
Social worker (e.g., case manager, school
counselor, supervisor, administrator)
Survivor empowerment, mentoring, or peer to peer
Violence prevention (e.g., Child abuse and neglect;
elder abuse; domestic violence, sexual violence,
youth violence)
Other (please specify):
_______________________________

30. In your professional capacity, how frequently do you come into contact with a person who is currently being trafficked, at
risk of being trafficked, or has been trafficked?
1

2

3

4

Never

Occasionally

Frequently

Daily

31. Which of the following best describes the number of years of experience you have in your current field of work?
□

Less than 3 years

□

3 to 5 years

□

□

6 to 10 years

More than 10 years

32. Which of the following best describes your primary role in your current position?
□
□
□

Direct delivery/Frontline staff
□ Consultant/Trainer
Management
□ Volunteer
Other (please specify): _______________

□
□

Administration
Peer educator

Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The estimated average time to complete this form is 5 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.

OMB Control Number: 0970-0519
Expiration Date: 10/31/2021

CONSULTANT
FEEDBACK
Form

33. Which of the following best describes your geographic population? (Mark all that apply.)
□ National
□ State (please specify): ______________
□ Tribal
□ International (please specify country):
_________________________________

□

Local
□ Urban
□ Rural
□ Suburban

34. Please select any of the following populations you currently work with in a professional capacity. (Mark all that apply.)









Human trafficking
 Commercial sexual exploitation of
children
 Sex trafficking
 Adults
 Minors
 Labor trafficking
 Adults
 Minors
Children/youth
 Out of home/Foster care/Kinship care
 Juvenile justice
 Runaway/Homeless youth
People with disabilities
Deaf/Hearing impaired
Elderly
Lesbian, gay, bisexual, transgender, and
questioning











Foreign nationals (migrant workers, undocumented
immigrants, refugees)
People with low incomes
Racial and ethnic minorities
 American Indian or Alaska Native
 Asian
 Black or African American
 Native Hawaii or other Pacific Islander
 White
 Hispanic or Latino ethnicity
History of substance use
Intimate partner violence (e.g., dating, domestic
violence)
Gang-related crime
Sexual abuse/Violence
Other (please specify): __________________

35. What is your race? (Mark all that apply.)
American Indian or Alaska Native
Asian
Black or African American
_______________________________________

Native Hawaii or other Pacific Islander
White
Other (please specify):

36. What is your ethnicity? (Mark all that apply.)
Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________
37. What is your gender? (Mark all that apply.)
Male
Female
Transgender
Other (please specify): ________________________________________

Thank you for taking the time to complete this form and helping to improve NHTTAC activities.
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The estimated average time to complete this form is 5 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.