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.

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

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

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

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

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

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

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

* 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)

* 9. In what community do you live?

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

Report a problem

T