FFF Corres Survey (Academy) * Indicates required field Academy Reference: 1. In the workplace, how often have you been a victim of verbal abuse in the last 12 months?: 1-2 times3-4 timesevery monthevery weekevery daynever 2. How often have you been threatened by a customer in the last 12 months?: 1-2 times3-4 timesevery monthevery weekevery daynever 3. Have you ever been a victim of physical violence from a customer?: YesNo Please tick this box if this physical violence was in the last 12 months.4. Can you tell us a little about the incidents of abuse/threats/violence you have experienced?: 5. If you have been affected, have you ever reported an incident to your employer?: YesNo 6. On a scale of 1 to 10, how supportive was your employer after you reported the incident?: 1 - unsupportive2345678910 - supportive 7. What more could your employer do to support shopworkers after an incident of verbal abuse, a threat or physical assault?: Management supportBan offendersBodycams, headsets, CCTV and signageMore securityBetter police involvement Other (please specify): 8. If you reported an incident, on a scale of 1 to 10, how confident are you that reporting abuse, threats and violence will make a difference?: 1 - Not at all confident2345678810 - Very confident 9. From the categories below, what do you believe have been the underlying factors triggering the abuse, threats and violence that you've experienced in the last 12 months? (please tick all that apply): Shoplifting: Due to addictionCost of livingOther Harassment: RacismSexismOther Frustration: Self-service checkout issuesLack of stockLack of staff Enforcement: Age restricted salesRefusing intoxicated customers Other (Please give details): 10. Do you agree that there needs to be a new law to protect retail workers?: YesNo 11. Are you a member of Usdaw?: YesNo 12. If not, would you like to join?: YesNo 13. Usdaw membership form (F1a) completed?: YesNo 14. Are you prepared to share your experiences?: YesNo Academy reference:* Employer: Location: First part of postcode: Store size: ConvenienceLarger store Age: Under 2728-5960+ Gender: Ethnicity: WhiteBlack or Minority Ethnic (please state below) Name: Home Tel No: Mobile: Email: Postcode:
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