0704-0604_Supplemental Survey_9.06.2023

Active Duty Spouse Survey

0704-0604_Supplemental Survey_9.06.2023

OMB: 0704-0604

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DRAFT ADSS Supplemental Survey (2023) OMB Control Number: 0604-0704

BACKGROUND INFORMATION

SRMRSTS

1. What is your marital status?

1

Shape1

Married

2

Shape2

Separated

3

Shape3

Divorced

4

Shape4

Widowed


ADSPSE

2. Is your spouse currently serving on active duty (not a member of the National Guard or Reserve)?

2

Shape5

Yes

1

Shape6

No




SRSEX

3. Are you...

1

Shape7

Male?

2

Shape8

Female?


SRHISPA

4. Are you Spanish/​Hispanic/​Latino?

1

Shape9

No, not Spanish/​Hispanic/​Latino

2

Shape10

Yes, Mexican, Mexican-American, Chicano, Puerto Rican, Cuban, or other Spanish/​Hispanic/​Latino


SRRACEA SRRACEB SRRACEC SRRACED SRRACEE

5. What is your race? Mark one or more races to indicate what you consider yourself to be.


Shape11

White


Shape12

Black or African American


Shape13

American Indian or Alaska Native


Shape14

Asian (e.g., Asian Indian, Chinese, Filipino, Japanese, Korean, or Vietnamese)


Shape15

Native Hawaiian or other Pacific Islander (e.g., Samoan, Guamanian, or Chamorro)


CHDHOME

6. Do you or your spouse have any children under the age of 18 living at home either part-time or full-time?

2

Shape16

Yes

1

Shape17

No


MILSAT

7. Overall, how satisfied are you with the military way of life?

5

Shape18

Very satisfied

4

Shape19

Satisfied

3

Shape20

Neither satisfied nor dissatisfied

2

Shape21

Dissatisfied

1

Shape22

Very dissatisfied


MILSTAY

8. Do you think your spouse should stay on or leave active duty?

5

Shape23

I strongly favor staying

4

Shape24

I somewhat favor staying

3

Shape25

I have no opinion one way or the other

2

Shape26

I somewhat favor leaving

1

Shape27

I strongly favor leaving


YOUR COMMENTS

COMM1IMP

9. Please share what the military could do to improve support for you and your family. Do not provide any personally identifiable information.




COMMQOL

10. Please describe the top issue(s) impacting the quality of life for you and your family. Do not provide any personally identifiable information.






THANK YOU

INELIGNODATA

INEL. [Ask if Q1 = "Widowed" OR Q1 = "Divorced" OR Q2 = "No"] Based on your answers to previous questions, you are ineligible to take this survey. If you feel you have encountered this message in error, click the back arrow button and check your answers.

For further help, please call our Survey Processing Center toll-free at 1-800-881-5307 or e-mail ADS- [email protected].


OPA 1

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleTab Order
AuthorHaynes, Jason D CTR DMDC
File Modified0000-00-00
File Created2023-11-06

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