This survey should take approximately 3- 5 minutes. Most questions are check offs. Your responses will help us know what you and other veterans needs are. This survey can be completed by a veteran or by his/her family or friend, please indicate in question 1. This survey is anonymous, unless you choose to identify yourself. Thank you.

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* 1. In which branch (or branches) of the United States military have you served? (Check all that apply)

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* 2. During what decades have you served? (Check all that apply)

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* 3. Are you a veteran of a war and/ or conflict? (Check all that apply)

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* 4. What type of assistance have you received from the VA? (Check all that apply)

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* 5. If any, please tell us what are your unmet needs? (Check all that apply)

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* 6. Are you interested in any of the following programs or services on a local (greater Ware/ Palmer) basis? (Check all that apply)

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* 7. If you checked "Drop- in center" above, please give us your preferences. (Check all that apply)

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* 8. Are there currently any barriers in your life that restrict you from seeking assistance from the VA or other organizations? (Check all that apply)

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* 9. In what community do you live?

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* 10. If you would like to be on our mailing list please provide your name and email.

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