INDIVIDUAL & DEPARTMENT INFORMATION

Currently, I am: (select all that apply)

Question Title

* 1. Currently, I am: (select all that apply)

What is your age?

Question Title

* 2. What is your age?

Which race/ethnicity best describes you? (Please choose only one.)

Question Title

* 3. Which race/ethnicity best describes you? (Please choose only one.)

Please select you gender.

Question Title

* 4. Please select you gender.

Which of the following best describes your current relationship status?

Question Title

* 5. Which of the following best describes your current relationship status?

What is the highest level of education you have completed?

Question Title

* 6. What is the highest level of education you have completed?

Do you work another job another than in your role as a first responder?

Question Title

* 7. Do you work another job another than in your role as a first responder?

What is your current status related to the military?

Question Title

* 8. What is your current status related to the military?

How many years have you been an EMT and/or paramedic? (If not applicable, leave blank)

Question Title

* 9. How many years have you been an EMT and/or paramedic? (If not applicable, leave blank)

How many years have you been a firefighter? (If not applicable, leave blank)

Question Title

* 10. How many years have you been a firefighter? (If not applicable, leave blank)

At what age did you start as an EMT/paramedic or firefighter?

Question Title

* 11. At what age did you start as an EMT/paramedic or firefighter?

What is the shift structure like where you work as a first responder?

Question Title

* 12. What is the shift structure like where you work as a first responder?

FOR FIREFIGHTERS ONLY: What is your current rank? (If not a firefighter, please skip to Question 15)

Question Title

* 13. FOR FIREFIGHTERS ONLY: What is your current rank? (If not a firefighter, please skip to Question 15)

FOR FIREFIGHTERS ONLY: Does an ambulance service currently run out of your fire department?

Question Title

* 14. FOR FIREFIGHTERS ONLY: Does an ambulance service currently run out of your fire department?

In which region of the state of Arkansas do you work as a first responder? (To enlarge the map, hold down "CTRL" and hit the +/= button on your keyboard).

Question Title

* 15. In which region of the state of Arkansas do you work as a first responder? (To enlarge the map, hold down "CTRL" and hit the +/= button on your keyboard).

In which type of setting do you work as a first responder?

Question Title

* 16. In which type of setting do you work as a first responder?

Which type of department/ unit do you work for?

Question Title

* 17. Which type of department/ unit do you work for?

What is the size of your department/ unit?

Question Title

* 18. What is the size of your department/ unit?

In your first responder role, have you ever responded to a suicide attempt or death? (select all that apply)

Question Title

* 19. In your first responder role, have you ever responded to a suicide attempt or death? (select all that apply)

MEDICAL HISTORY: Have you ever been diagnosed with any of the following medical problems? (Check all that apply)

Question Title

* 20. MEDICAL HISTORY: Have you ever been diagnosed with any of the following medical problems? (Check all that apply)

Have you ever been diagnosed with a mental health problem?

Question Title

* 21. Have you ever been diagnosed with a mental health problem?

Have you ever received treatment for a mental health problem?

Question Title

* 22. Have you ever received treatment for a mental health problem?

Do you now, or have you ever, taken medications for a mental health problems?

Question Title

* 23. Do you now, or have you ever, taken medications for a mental health problems?

Page1 / 10
 
10% of survey complete.

T