National Survey of Veterans, Active Duty Service Members, Activated National Guard and Reserve Members, Family Members and Survivors

Department of Veterans Affairs
National Survey of Veterans (NSV)

Active Duty Service Member Survey

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information
unless it displays a valid OMB control number. The valid OMB control number for this information collection is xxx-xxxx.
The time required to complete this information collection is estimated to average 15 minutes per response, including the
time to review instructions, search existing data resources, gather the data needed, and complete and review the
information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving
this form, please write to: VA, xxxx

If you have any questions or concerns, please call the NSV Survey Helpline at 1-888-NSV-2009 or send an
email to NSV@westat.com

Instructions to Complete the Survey



To answer a question, simply check the box that best represents your answer.



You will sometimes be asked to skip questions based on your answers. In addition, certain
sections of the questionnaire may not apply to you.



Please choose only one answer per question, unless the question indicates Mark all that
apply.

Section B
Familiarity With VA Benefits and Services
B1. Below is a list of topics about VA benefits and
services. Please indicate whether you have
looked for information on these in the past 12
months.

Section A
Background Questions
A1. Are you currently on full-time active duty?
Yes  Go to Question A2
No

Yes No

A1a. Thank you. This survey is intended for those
currently serving on active duty. Please return
the survey in the enclosed pre-paid return
envelope.

a. Eligibility for VA health care

A2.

d. VA home loans

b. VA health care facility locations
c.

In what year did you first enter active duty?

VA life insurance

e. VA education and training

Year

f.

VA vocational rehabilitation

g. VA burial and memorial benefits

A3.

In which branch of the Uniformed Services
are you currently serving?

h. VA disability compensation and pension

Army

i.

VA benefits for dependents and survivors

j.

VA prescription benefits

Navy
Air Force

B2.

Marine Corps
Coast Guard

Please indicate your level of awareness for
the following VA benefits and services:

Other (e.g., the Public Health Service, the
Environmental Services Administration, the
National Oceanic and Atmospheric
Administration, U.S. Merchant Marine)

A4.

A5.

a. Eligibility for VA health care

During active duty have you ever been
exposed to dead, dying, or wounded people?

b. VA life insurance

Yes

c.

No

d. VA education and training
e. VA vocational rehabilitation

Were you ever a prisoner of war?

f.

Yes

VA burial and memorial
benefits

g. VA disability compensation
and pension

No

A6.

VA home loans

h. VA benefits for dependents
and survivors

During your military service, have you ever
been exposed to environmental hazards such
as Agent Orange, chemical warfare agents,
ionizing radiation, or other potentially toxic
substances?

i.

Definitely Yes
Probably Yes
Probably No
Definitely No
Don’t know

1

VA prescription benefits

B3.

The new Post-9/11 GI Bill may allow for
transfer of education benefits by an eligible
servicemember to his or her spouse or
dependent child.

B5a. Of all the information sources you have used,
which one was the most difficult to use?
VA web site (www.va.gov)
Veteran service organization (e.g., American
Legion, Veterans of Foreign Wars – VFW,
etc.)

Does
not
Yes No apply

My local VA office

a. Would you consider transferring
your entitlement to education
benefits to your spouse?

VA health care facility
VA Toll-Free Help Line

b. Would you consider transferring
your entitlement to education
benefits to your dependent child?

B4.

VA Veterans Benefits Handbook
A Veteran
Other  Please specify below

Overall, how satisfied or dissatisfied are you
with available information about VA benefits
and services?
Very satisfied
Satisfied

B5b. Of all the information sources you have used,
which one was the easiest to use?

Neither satisfied nor dissatisfied
Dissatisfied

VA web site (www.va.gov)

Very dissatisfied

B5.

Veteran service organization (e.g., American
Legion, Veterans of Foreign Wars - VFW,
etc.)

In the past year have you used any of the
following sources to get information about VA
benefits and services? Mark all that apply.

My local VA office
VA health care facility

VA web site (www.va.gov)

VA Toll-Free Help Line

Veteran service organization (e.g., American
Legion, Veterans of Foreign Wars - VFW,
etc.)

VA Veterans Benefits Handbook
A Veteran

My local VA office

Other  Please specify below

VA health care facility
VA Toll-Free Help Line
VA Veterans Benefits Handbook
A Veteran
Other  Please specify below

B6.

How would you most prefer to get answers to
your VA questions?
Mail
Telephone
Email

Have not sought information about VA
benefits and services  Go to Question B6

Face to face
Internet site

Question B6 appears in the next column.

2

B7.

How would you least prefer to get answers to
your VA questions?

Section D
Education and Training

Mail

These next few questions ask about your experience
with education and training benefits.

Telephone
Email
Face to face

D1.

Internet site

Have you ever used the military’s Tuition
Assistance (TA) program?
Yes
No

Section C
Health Status
C1. In general, would you say your health is…

D2.

Excellent

Have you used any VA education or training
benefits? Do not include the military’s Tuition
Assistance program.

Very good

Yes

Good

No  Go to Question D3

Fair
Poor

D2a. How did you use the VA education benefit?
Mark all that apply.

C2.

Do you plan to use VA health care services
once you separate from active duty service?

Took college or university coursework leading
to a bachelor or graduate degree

Yes  Go to Question C3

Attended business, technical or vocational
school training leading to a certificate or
diploma

No
Not Sure Go to Section D

Participated in an apprenticeship or on-job
training program

C2a. Why do you not plan on using VA health care
services?  Please specify below

Took correspondence courses
Took flight training
Received tutorial assistance, refresher
courses, or deficiency training
Attended a teacher certification program
Did something else  Please specify below

QUESTION C2a SKIPS TO SECTION D
IN THE NEXT COLUMN 

C3.

Which of the following best describes the
primary way you plan on using VA Health
Care in the future? Mark only one.

D2b. Did you complete your training, or receive the
primary degree or certificate for which you
were enrolled and receiving VA education
benefits?

Your primary source of healthcare
Backup to non-VA care for some minor
services
A “safety net” to use only if needed

Yes

For prescriptions

No

For specialized care
Some other way
Section D appears in the next column.

Question D3 appears on the next page.

3

D2c. How important were your VA education
benefits in helping you meet your educational
goals?

E2.

Extremely important

Yes

Very important

No

Moderately important
Slightly important

E3.

Not at all important

Other than SGLI, do you have life insurance
coverage through any other organization?
Yes

QUESTION D2c SKIPS TO SECTION E
BELOW 

D3.

Are you aware that you can convert your
SGLI to Veterans’ Group Life Insurance
(VGLI) after you are discharged from the
service?

No

What are the reasons you haven’t used any
of the VA education or training benefits? Mark

Section F
Home Loans
F1. What would you say your current living
arrangement is?

all that apply.

Not aware of VA education or training benefits
Don’t believe I’m entitled to or eligible for
education or training benefits

Live in military housing

Plan on using after I leave active duty service

Rent my home

Using Tuition Assistance (TA) instead

Own my home—with an outstanding
mortgage

Too busy to use the benefit
Chose not to contribute to the Montgomery GI
Bill

Own my home—no mortgage balance
Occupy dwelling with no payment of cash rent

Don’t need any additional education or
training

Other

Other  Please specify below

F2.

Have you ever obtained a home loan to
purchase a home, refinance a home loan or
make home improvements?
Yes
No  Go to Section G

Section E
Life Insurance
E1. Do you have Servicemembers’ Group Life
Insurance (SGLI)?

F2a. When obtaining financing for your loan, did
your lender discuss VA's home loan guaranty
program with you as a possible option?
Yes

Yes

No

No

Don’t remember

F3.

Are you aware that VA has a home loan
guaranty program for eligible
servicemembers?
Yes
No

Section G appears on the next page.

4

F4.

Have you ever used the VA home loan
guaranty program?

F7.

Yes, currently have VA home loan

A conventional FHA mortgage was easier or
less expensive for me to obtain

Yes, not currently, but have had VA home
loan in the past

I applied for a VA home loan, but did not
qualify

No, never have had VA home loan  Go to
Question F7

F5.

I did not apply because I did not think that I
would qualify

How long ago did you obtain your most
recent home loan (VA or other)?

I thought that the process for obtaining a VA
home loan would take too long
My lender and/or realtor discouraged the use
of the VA program

Within last 5 years
6-10 years ago

The VA funding fee was too high

11-20 years ago

I didn’t know about the program

More than 20 years ago

F6.

If you have not used the VA home loan
program, what was the main reason you did
not?

Other  Please specify below

What is the most important reason you
chose to get a VA home loan?
VA home loan program is offered only to U.S.
military and Veterans
No down payment required
Convenience

Section G
Burial Benefits
G1. How satisfied are you with your ability to get
accurate information about your burial
benefits?

No mortgage insurance required
Loan more likely to be approved
VA’s assistance to avoid foreclosure
Previous experience with the VA home loan
program

Does not apply, I have not tried to get
information
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied

QUESTION F6 SKIPS TO SECTION G
ON THE NEXT PAGE 

G2. Have you ever visited a VA National
cemetery or shrine honoring Veterans?
Yes
No

Question F7 appears in the next column.

5

G3. How important to you are the following factors
to maintaining VA National cemeteries as
shrines that honor Veterans?

Section H
Burial Plans
H1. What type of burial do you think you'll have?
In-ground, casket burial
Cremation, in-ground burial
Cremation columbarium (a vault for cremated
remains)

a. Maintenance of the
cemetery grounds
b. Upkeep of headstones,
markers, and wall covers for
cremated remains
c. Maintenance of other
landscape features
d. Appearance of committal
shelters
e. Appearance of individual
gravesites
f. Maintenance of cemetery
buildings and roads
g. Cemetery’s front gate and
entrance area
h. Availability of parking and/or
restrooms
i. Public ceremonies and
events that honor Veterans
j. Presentation of military
funeral honors
k. Other  Please specify
below

Mausoleum (i.e. tomb within a monument or
building)
Something else
Don’t know

H2.

Do you plan to be buried in a VA National or
State Veterans cemetery?
Yes
No  Go to Question H3
Don’t know

H2a. What are your reasons for planning to be
buried in a VA National or State Veterans
Cemetery? Mark all that apply.
No cost
Friends or family buried there
Quality of services
The honor of burial in a VA National shrine
My connection to the military/past service to
country
Other  Please specify below

G4. Please indicate if you have heard about the
following burial benefits before filling out this
survey.

Don’t

Yes No know

Don’t Know

a. Burial at a VA National or State
Veterans cemetery
b. Headstone and burial markers
provided by VA at private
cemeteries
c.

QUESTION H2a SKIPS TO QUESTION H5
ON THE NEXT PAGE 

Presidential Memorial Certificates
for next of kin

d. Cash plot allowance
e. Cash burial allowance
f.

Military Funeral Honors

g. Receiving a U.S. Flag
Question H3 appears on the next page.

6

H3.

What would you say are your main reasons
for not planning to be buried in a VA National
or State Veterans cemetery? Mark all that

H4a. What are the main reasons you don’t plan to
use a headstone or marker provided by VA?
Mark all that apply.

apply.

Don’t know eligibility criteria

Don’t know about headstones and markers for
Veterans

Quality of services

Made other arrangements

Don’t know how to make arrangements with
VA

Wants headstone similar to other family
members

Made other arrangements

Don’t like VA headstones and markers

VA services don’t accommodate religious
preferences

Other  Please specify below

Veterans cemetery too far away (distance)
Travel time to Veterans cemetery too long
Appearance of cemetery doesn’t meet my
expectations

Don’t know

Wanted location close to other family
members

H5.

Wanted services that weren’t available at
Veterans cemetery
Too difficult to make arrangements with VA

Preferable

= Your first choice (choose one)

Unable to make advance arrangements with
VA

Acceptable

= Not your first choice, but would
be OK

Other  Please specify below

Unacceptable = You would never choose this
type of burial

Don’t Know

H4.

For each of the burial options listed below,
please tell us if you consider the option
preferable, acceptable, or unacceptable.

a. Casket burial, in-ground
b. Casket burial, in a mausoleum

If you choose to be buried in a private
cemetery, do you think you'll have your burial
place marked by a headstone or marker
provided by VA (at no cost to you)?

c.

d. Cremation, ashes placed in a
columbarium
e. Cremation, ashes scattered

Yes  Go to Question H5

f.

No
Don’t know  Go to Question H5

Question H5 appears in the next column.

Cremation, ashes buried in-ground

7

Cremation, ashes kept by my family

I6.

Section I
Internet Use
I1. Do you use the Internet, at least
occasionally?
Yes

a. Obtaining news and
information

No  Go to Question I4

I2.

How willing are you to use the Internet for the
following activities?

b. Carrying out research on
services

How often do you access the Internet or
World Wide Web?

c.

At least once a day

Purchasing goods or
services

d. Responding to polls or
surveys

At least once a week but not every day
At least once a month but less than once a
week

e. Obtain information about VA
benefits

At least once a year but less than once a
month

f.

Apply for VA benefits

Less than once a year

I7.
I3.

Where do you go on-line to use the Internet?
Mark all that apply.

Would you like to receive VA information
through the Internet or the World Wide Web?
Yes
No

Home
Work

I8.

School
Public library
Community center
Someone else’s house

Have you ever accessed a website for
transition assistance, employment
assistance, or to obtain information on
benefits and services available to Veterans
and/or transitioning servicemembers?
Yes

Some other place

No

I4.

Do you send or receive emails, at least
occasionally?
Yes

Section J
Demographics
J1. What is your gender?

No  Go to Question I6

I5.

Where do you go on-line to send or receive
emails? Mark all that apply.

Male
Female

Home
Work

J2.

School

What is your year of birth?
Year

Public library
Community center
Someone else’s house
Some other place
Question I6 appears in the next column.

8

J3.

J4.

Please indicate the number of dependent
children you have.

J6.

What is your race? Mark all that apply.
White

Number of minor children
(age 17 and younger)

Black or African American

Number of adult children attending
High School and/or College (age 18-22)

Asian Indian

American Indian or Alaska Native
Chinese

What is the highest degree or level of school
you have completed?

Filipino

Less than high school

Other Asian (for example, Hmong, Laotian,
Thai, Pakistani, Cambodian, and so on)

High school diploma / GED

Native Hawaiian

Some college credit, but less than one year of
college credit

Guamanian or Chamorro

One or more years of college credit, no
degree

Other Pacific Islander (for example, Fijian,
Tongan, and so on)

Samoan

Associate’s degree (for example, AA, AS)
Bachelor’s degree (for example, BA, BS)

J7.

Master’s degree (for example, MA, MS,
MEng, MEd, MSW, MBA)

Now married

Professional degree beyond a bachelor’s
degree (for example, MD, DDS, DVM, LLB,
JD)

Divorced

Widowed
Separated

Doctorate degree (for example, PhD, EdD)

J5.

What is your current marital status?

Never married

Are you of Hispanic, Latino, or Spanish
origin?
No, not of Hispanic, Latino, or Spanish origin
Yes, Cuban
Yes, Mexican, Mexican American, Chicano
Yes, Puerto Rican
Yes, another Hispanic, Latino, or Spanish
origin For example: Argentinean,
Colombian, Dominican, Nicaraguan,
Salvadoran, Spaniard, and so on  Please
specify below

Thank you for your participation
in this very important survey.

9

If found please return to:
Westat
1600 Research Blvd, RA 1136
Rockville, MD 20850