Thank you for taking the Social Determinants Assessment. The purpose of this assessment is to help identify areas where you need assistance as well as help your Navigator determine how they can best help you secure the necessary resources and services to make your transition a success.
Please answer each of the 19 question with respect to how often you feel your specific needs are being met in the past 30 days.
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Thank you for completing the Social Determinants Assessment. The purpose of this assessment is to help identify areas where you need assistance as well as help your Navigator determine how they can best help you secure the necessary resources and services to make your transition a success.
Please email the results of this Assessment to your Navigator.
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Question 1 of 20
1. Question
My Health
With respect to the last 30 days I feel my needs are being met
Never[1], Rarely [2], Sometimes [3], Often [4], Always [5]
My physical health needs are being met
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Never Always
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Question 2 of 20
2. Question
My mental health needs are being met
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Never Always
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Question 3 of 20
3. Question
My nutritional needs are being met.
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Never Always
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Question 4 of 20
4. Question
I find time for recreation/leisure activities
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Never Always
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Question 5 of 20
5. Question
My Physical Environment
With respect to the last 30 days I feel my needs are being met
Never[1], Rarely [2], Sometimes [3], Often [4], Always [5]
I feel safe
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Never Always
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Question 6 of 20
6. Question
My housing needs are being met.
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Never Always
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Question 7 of 20
7. Question
My housing goals are being met
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Never Always
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Question 8 of 20
8. Question
I have reliable transportation
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Never Always
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Question 9 of 20
9. Question
My Economic Stability
With respect to the last 30 days I feel my needs are being met
Never[1], Rarely [2], Sometimes [3], Often [4], Always [5]
I feel satisfied with my employment
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Never Always
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Question 10 of 20
10. Question
I can meet my financial obligations
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Never Always
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Question 11 of 20
11. Question
My dependent (child or elder) care needs are being met
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Never Always
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Question 12 of 20
12. Question
My Social Connections
With respect to the last 30 days I feel my needs are being met
Never[1], Rarely [2], Sometimes [3], Often [4], Always [5]
I have family support
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Never Always
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Question 13 of 20
13. Question
I have social support
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Never Always
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Question 14 of 20
14. Question
I have community/cultural/spiritual support
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Never Always
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Question 15 of 20
15. Question
My Education
With respect to the last 30 days I feel my needs are being met
Never[1], Rarely [2], Sometimes [3], Often [4], Always [5]
My educational goals are being met
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Never Always
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Question 16 of 20
16. Question
I have access to educational, training, and development opportunities
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Never Always
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Question 17 of 20
17. Question
My Legal Needs
With respect to the last 30 days I feel my needs are being met
Never[1], Rarely [2], Sometimes [3], Often [4], Always [5]
I have the legal support I need
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Never Always
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Question 18 of 20
18. Question
Benefits
Have you applied for military/veteran benefits?
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Question 19 of 20
19. Question
Have you enrolled in the Veterans Health Administration?
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Question 20 of 20
20. Question
Have you contacted your County Veteran Service Officer (CVSO)?
