Creative Expressive Arts Session Survey_ Previous Participants

Information to Assist Us in Providing the BEST Creative Expressive Arts Programs

We are reaching out to you as a previous participant in at least one of our creative expressive arts programs. In order to improve our creative expressive art services we would like to ask you to take a few minutes to complete this short survey. Thank you for your time and the valuable information that you will provide. All information is anonymous.

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* 1. Choose your current military status (choose all that apply)

Active Duty

Reservist (to include Guard) on Active Duty

Reservist (to include Guard)

Pre-deployment Status

Post-deployment Status

Medical Board Process

Retired

Medically Retired

Active Enlistment Ended

Veteran Status

Pre-911

Post-911

Family/ Significant Other

Child/ Other Dependent

Hospital Staff-Contractor

Hospital Staff- Civilian

Hospital Staff - Military

Additional Information if needed or not included in the list of choices

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* 2. What is your gender?

Female

Male

Non Binary/Third Gender

Prefer to self-describe (in below comment box)

Prefer not to provide this information

Other (please specify)

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* 3. What facility or facilities did you attend a creative expressive art program?

Walter Reed National Military Medical Center

Fort Belvoir Community Hospital

Community Location (Please specify in additional information box)

Other (Please specify in additional information box)

Additional Information

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* 4. How did you hear about the creative expressive art session the you attended?

Friend

Family

Hospital Staff

Provider (physician) Referral

Additional information you would like to provide

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* 5. What kind of creative expressive art session did you attend?

Creative Writing

Visual Art

Music

Improv

Additional information you would like to provide

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* 6. How did the creative expressive arts session(s) that you attended benefit or impact you?

Laughter

Socialization (increase connection with others)

Creative Outlet

Learning something new

Improved Mood

Complements traditional care

Self-Care

Senses of Community and Connection with others

Supports Treatment Plan

Career/Vocational Skill Building

Sense of Purpose

No Benefit

Unknown, have not thought about it

Additional Information that you would like to share

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* 7. Since your first experience with creative expressive arts how often have you participated in a creative expressive art program?

Weekly

Monthly

Every 2 -4 months

Yearly

N/A, my first experience or just the one time

Other (specify in the additional information box below)

Additional Information

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* 8. Please provide the current city and state you are living.

City/Town

State/Province

Country

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* 9. If different than the previous question, what city and state will you be returning to after you separate from service?

City/Town

State/Province

Country

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* 10. Would you participate in a creative expressive art workshop if it was offered online or at location near your home?

Yes

Possibly

Online

In person workshop

List type of creative expressive art program of interest (writing, performing, music, creating art).

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* 11. Please add any comments/ feedback you'd like to share to help us improve our services.

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* 12. If you would like to receive additional information on upcoming creative expressive art programs please send an email to contact@communitybuildingartworks.org