East Buffalo Veterans Study

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please help us learn more about the needs of Veterans in East Buffalo by taking 5-10 minutes to answer a few questions. Thank you!

Are you a Veteran? *

Yes

How old are you? *

18-29

30-45

46-60

60+

Do you live in East Buffalo? *

Yes

What is your race / ethnicity? (optional)

African American

Asian

Hispanic / Latino

Native American

Caucasian

Multi-racial

Alaskan Native / Pacific Islander

Other

Clear selection

If you are a Veteran, where do you go to find services locally?

Based on what you know, what is the highest need for Veterans living in East Buffalo? *

Is there anything else that might help us understand the needs of Veterans living in East Buffalo? *

Please rate, from 1-5, the services most needed in East Buffalo: *

1 (No Need)

2 (Low Need)

3 (Some Need)

4 (Moderate Need)

5 (Highest Need)

Housing

Health Care

Transportation

Counseling / Mental Health

Employment

Education

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Olmsted Center for Sight.

Does this form look suspicious? Report