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Surveys
2015
March
M
Military/Veteran Suicide
Military/Veteran Suicide
0%
Exit Survey
Hello: Thank you for taking time to participate in my survey on suicide. The purpose of the survey is to collect data for the book I'm writing on Suicide an Epidemic in America. The book is being written to help bring awareness to the epidemic at hand. The desire was put in me to help bring people out of darkness into the light. My goal is to shed light where there is no light, bring hope where there is no hope, and show love where there is no love.
Your participation in this study is completely voluntary. If you feel uncomfortable answering any questions, you can withdraw from the survey at any point. Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. Thank you very much for your time and support. Please start with the survey now by clicking on the
Continue
button below.
Have you served in the military?
Yes
No
Did you go to war?
Yes
No
What would you say is the difference between the wars of old and the wars of today?
How are you transitioning from a military lifestyle to a civilian lifestyle?
Have you ever felt: (Select all that apply)?
Depressed
Anxious
Sad
Worthless
Unloved
Broken on the inside
Like no one understands you
Hopeless
Have you suffered from a trauma?
Yes
No
What does suicide mean to you?
Do you have a means to hurt yourself?
Do you use alcohol or substance to self-medicate?
Yes
No
Are there recent stressors in your life (Select all that apply)?
Job loss
disappointment
hurt
eviction
family problems
substance abuse
homeless
finance problems
abuse (physical or mental)
care taker for mentally challenged or disabled child
care taker for elderly parent/grandparent
Do you hear voices or see things? (Audio/Visual Hallucinations)
Yes
No
Have you ever been diagnosed with an incurable disease?
Yes
No
Is suicide your last resort? if yes, what else have your tried?
Tell me your story:
Gender
Male
Female
Ethnicity
Caucasian
African American
Hispanic
Asian
Native American
Multi-race
Age range
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65=69
70+
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