If you fit multiple categories, please feel free to complete all surveys that apply to your situation.

Friends and Family Survey

Name

Age

Gender

Phone

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?

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?

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?

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.)

Have you personally been affected by a veteran’s suicide?

If yes, how many

Has a veteran you know ever suffered from suicidal ideations?

Have you ever known a family member of a veteran who committed suicide?

Are you currently divorced from a veteran?

Has your veteran’s physical or mental health ever created a mental or financial strain in your relationship?

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?

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?

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?

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?