If you fit multiple categories, please feel free to complete all surveys that apply to your situation.
Thank you for taking the surveys. Fidelis Family Retreat will not sell or share your personal information. Survey responses will only be used for the purpose of this study to show the needs for veteran families.
Friends and Family Survey
First Initial
Last Name
Age
Gender
Phone
Email
What state are you a resident of?
To help verify results with the VA, please list at least one veteran's name with whom you are connected.
What is your Veterans disability rating from the Department of Veteran Affairs (VA)?
Are you aware of any local or community support groups that are available to you or your veteran?
Please select...
Yes
No
If yes, which ones
Are you aware of any resources that are available to family members that the veteran does NOT have to initiate or participate in?
Please select...
Yes
No
If yes, which ones
Do you currently use the VA system to receive any services? If yes, what services do you receive from the VA?
Please select...
Yes
No
If yes, which ones
Would you or your family benefit from having direct access to a local veteran family member support officer?
(eg. resources specific to veteran life, VA navigation, suicide prevention classes, PTSD/TBI information and support, veteran children resources and classes, etc.)
Please select...
Yes
No
Have you personally been affected by a veteran’s suicide?
Please select...
Yes
No
If yes, how many
Has a veteran you know ever suffered from suicidal ideations?
Please select...
Yes
No
Have you ever known a family member of a veteran who committed suicide?
Please select...
Yes
No
Are you currently divorced from a veteran?
Please select...
Yes
No
N/A
Has your veteran’s physical or mental health ever created a mental or financial strain in your relationship?
Please select...
Yes
No
After leaving active duty, did you or your veteran suffer undue stress or neglect your mental health due to the requirement for health insurance and/or financial security?
Please select...
Yes
No
N/A
Would one year of free or low-cost medical insurance have helped to ease the transition from active duty to veteran life and would it have encouraged you or your veteran to engage in self-care through the VA?
Please select...
Yes
No
N/A
specific to Dependent family members only
Do you feel that you were not entitled to services or did not receive services provided by the VA or other support organizations because your veteran failed to meet specific eligibility criteria? For example: because of your veteran’s discharge rating, your veteran was not a purple heart recipient or a combat veteran family?
Please select...
Yes
No
What type of family services or activities would you like to see provided that you or family would benefit from?
Were there any transitional services that you or your family needed that would have made your transition from active duty to veteran life easier and more successful?