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Where are you located?
 
Kuwait (Arifjan)
 
Kuwait (Virginia)
 
Kuwait (Buehring)
 
Kuwait (Ali Al Salem)
 
Ft. McPherson
 
Shaw AFB
 
Other
 
 
 
Is your family's religious needs being meet?
 
Yes
 
No
 
 
 
Have you ever seen your chaplain?
 
Yes
 
No
 
 
 
What is your religious preference?
 
Catholic
 
Protestant
 
Buddhist
 
Islam
 
Jewish
 
Hindu
 
Agnostic
 
Atheist
 
No religious Pref
 
Other
 
 
 
What kind of training at retreats would you like?
 
Family
 
Finance
 
Forgiveness
 
Choosing a Parter
 
Bonding with Spouse
 
Other
 
 
 
Answer the following questions according to the degree to which you agree with the statement. If you completely disagree with the statement, place a tick mark besides the wording "Completely false". If you completely agree with the statement, place a tick mark besides the wording "Completely True". These are the two extreme. You can answer anywhere in between. Remember to place the tick mark by the answer that represents closet to your belief.
 
 
 
I am receiving the religious support I need.
 
Completely true
 
Mostly true
 
Somewhat true
 
Somewhat false
 
Mostly false
 
Completely false
 
 
 
I am depressed but don't want to see anyone.
 
Completely true
 
Mostly true
 
Somewhat true
 
Somewhat false
 
Mostly false
 
Completely false
 
 
 
I am depressed and want to see the chaplain.
 
Completely true
 
Mostly true
 
Somewhat true
 
Somewhat false
 
Mostly false
 
Completely false
 
 
 
I often feel suicidal but afraid to ask for help.
 
Completely true
 
Mostly true
 
Somewhat true
 
Somewhat false
 
Mostly false
 
Completely false
 
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