Form VRCN Wireframe 6.1 VRCN Wireframe 6.1 VRCN Wireframe 6.15.23

OMB Number: 2900-0876

Expiration: 2/28/2026

Estimated Burden: 5 minutes

The VA provides free, confidential support 24/7 for Veterans and their family and friends. If you are in crisis, contact the Veterans Crisis Line: Dial 988 (Press 1) or 1 (800) 273-8255 (Press 1), text 838255, or visit https://www.veteranscrisisline.net. If you are homeless or at risk of homelessness, contact the National Call Center for Homeless Veterans (NCCHV) by dialing 1 (877) 424-3838 or visiting https://www.va.gov/HOMELESS/.

Help us serve you better.

The VetResources Community Network (VRCN) is the VA’s front door for community and strategic partners collaboration to meet community needs, maximize outreach capabilities, build trusted relationships, increase access to VA health and benefits and provide tools to better serve their Veteran community.

We want to hear about your experience with the VetResources Community Network (VRCN). By responding to this survey, you will directly help us partner more successfully with community partners and collaborators to better serve Veterans, their families, and survivors.

This survey should take approximately 5 minutes to complete.

First Name

Last Name

Phone Number

Email

Name of Organization

I received valuable information at this event.

I would recommend other community partners serving Veterans and their families to join the VRCN.

Please explain why you selected this response.

0/400

Logic: if the respondent selects option 1 or 2 comment box appears

I was able to network with other community partners to bridge gaps in services and better meet the needs of the community my organization serves.

What other topics would you recommend for the next VRCN event?

0/400

What does your organization need from VA for outreach and community engagement? (Select all that apply)

□ Regional/Local Communications and Outreach Support

□ State/county focused resources

□ National Communications and Outreach Support (VA Blog post/VetResources Newsletter)

□ Event Posting on VA outreach and event page

□ Connection to local VHA/VBA/NCA leadership

□ VA expertise and engagement for a community event/convening/conference

□ Connection to another partner organization

□ Support to build a coalition or CVEB

□ Consult with overview of Community Tools and Playbook

What does your organization need from community partners and VSOs to best support Veterans, families, caregivers, and survivors? (Select all that Apply)

□ Referral Mechanisms

□ Technology Solutions

□ Funding

□ Outreach Support

□ Data/Research

□ Event Coordination

What are your top focus areas now? (Select all that Apply)

□ Veterans

□ Caregivers/Survivors

□ Minority Veterans (Women, African American, AANHPI, Tribal, LGBTQ+)

□ Homelessness/ Food Security

□ Financial Readiness

□ Education/ Employment

□ Community Partner Support

□ Communication, Outreach, Social Networking

□ Suicide Prevention/ Mental Health

□ Veteran Technology Solutions

□ Other

How many Veterans and their families, caregivers, and survivors does your organization currently serve or reach in a given year?

Number Free Text Field

I trust VA to provide Veterans and their families with the care and services needed.

Required

Is your organization part of or leading a Community Veteran Engagement Board? (CVEB)

O Yes

O No

Have you accessed the VetResources Community Idea Lab?

O Yes

O No

By filling out this survey, you are authorizing VA database access to retrieve Veteran contact information to follow up with you accordingly for purposes of service recovery, potential crisis, or to learn more about feedback you have shared regarding your experience with VA.

VA may utilize individual Veteran survey data from this survey or other sources to ensure the final scores truly and accurately represent the experiences of Veterans.

This information is collected in accordance with section 3507 of the Paperwork Reduction Act of 1995. Title 38, United States Code, allows us to ask for this information. We estimate that you will need an average of 5 minutes to review the instructions and complete this survey. The results of this survey will be used to inform opportunities for program improvement in the quality of VA services. Participation in this survey is voluntary, and your decision not to respond will have no impact on VA benefits or services which you may currently be receiving. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at https://www.reginfo.gov/public/do/PRAMain. Information gathered will be kept private to the extent provided by law. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden to [email protected]. VA will not disclose your personal information to third parties outside VA without your consent or when immediately responding to an expressed concern or need for immediate information or resources.