Survey Form - vcp-llc

Select the option that best describes you.

Have you ever used the VA for any health care services?

Select your military branch.

How do you currently describe yourself ?

I use a different term

Are you of Hispanic, Latino, or Spanish origin?

Which of the following best represents how you think of yourself?

I use a different term

What best describes the role(s) Veterans have in your life?

Other

Select the year that you discharged from military service.

When did you last use the VA for health care services?

Please indicate whether you served in any of the following military conflicts.

Please indicate whether you served in any of the following military conflicts. (Other)

Select the year that you were born.

Select the race for which you most closely identify.

Some Other Race

Select your marital status.

May we have your zip code?

Are you aware of the 988 Press 1, Veteran Crisis Line?

How did learn about the 988 Press 1, Veteran Crisis Line?

Other

Do you recall hearing about or seeing the 988 Press 1, Veteran Crisis Line online or on social media?

How likely are you to like, save, share, or comment on 988 Press 1, Veteran Crisis Line online or social media messages?

Who have you shared this post with?

Other

Did you like, save, share, or comment on the 988 Press 1, Veteran Crisis Line online or social media message?

Have you ever shared 988 Press 1, Veteran Crisis Line posts or messages with others?

Have you ever used the 988 Press 1, Veteran Crisis Line?

Do you recall when you last used the 988 Press 1, Veteran Crisis Line?

How likely are you to use the 988 Press 1, Veteran Crisis Line if you or a loved one are facing a crisis?

How have you used the 988 Press 1, Veteran Crisis Line?

Have you ever referred someone in a crisis to the 988 Press 1, Veteran Crisis Line ?

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