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  2. 2016
  3. September
  4. V
  5. Veteran Demographics
0%
Exit Survey
 
 
What is your age?
 
18-24
 
25-34
 
35-44
 
45- 54
 
55+
 
 
 
What is your gender 
 
Male
 
Female
 
 
 
Where did you serve?
 
Vietnam
 
Korea
 
Operation Iraqi Freedom/Operation Enduring Freedom
 
Other
 
 
 
How far do you travel to the Travis Manion Foundation Facility?
 
less than 5 miles
 
5-10 miles
 
10-20 miles
 
Greater than 20 miles
 
 
 
Which of the following devices do you have access to ? ( Select all that apply)
 
Smartphone
 
Computer
 
Tablet

 
 
 
Do you have access to Wifi?
 
Yes
 
No
 
 
 
Have you experienced any of the following? ( Select all that apply)
 
Problems Concentrating
 
Problems Sleeping
 
Repeated, distressing memories and/or dreams
 
Acting or feeling as if you were reexperiencing a distressing event
 
Intense physical and/or emotional distress when reminded of a particular event
 
Irritability or outbursts of anger
 
An exaggerated startle response
 
Feeling "on guard"