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Community Wellness and Support Questionnaire

Veterinary Community Wellness & Support Questionnaire

Anonymous – Optional Follow-Up Available This questionnaire is designed to better understand the needs of veterinary professionals in our local community. Your responses will help guide locally focused scholarship opportunities, mentorship programs, and mental health support initiatives. This work is being informed by partnerships with external, local licensed mental health professionals to help ensure our approach thoughtfully supports the mental health needs of our community. Your responses are anonymous unless you choose otherwise. You are not required to provide identifying information to complete this form. If at any point you would like direct support, mentorship, or guidance, you may choose to visit drcookevet.com or complete our optional follow-up support form.

This field is for validation purposes and should be left unchanged.

Section 1: About You (Non-Identifying)

Section 2: Well-Being & Work Experience

Which of the following have you experienced? (Check all that apply)(Required)

Section 3: Support & Connection

The following questions help us understand what types of support are already available to you and where additional support may be helpful. There are no right or wrong answers.
Which types of support would be most helpful to you right now?(Required)
Examples may include a therapist, counselor, psychologist, psychiatrist, or other licensed provider.
What factors most influence whether you participate in support programs?(Required)

Section 4: Safety Check

The following questions are optional and help us understand how best to support you. This form is not monitored in real time and does not replace emergency care. If you are in immediate danger, please contact local emergency services or the Suicide & Crisis Lifeline (U.S. 988).
In the past few weeks, have you wished you were dead or wished you could go to sleep and not wake up?(Required)
In the past few weeks, have you felt that you or your family would be better off if you were dead?(Required)
In the past week, have you had thoughts about killing yourself?(Required)
Have you ever tried to end your life?(Required)
Are you having thoughts of killing yourself right now?(Required)

Section 5: Optional Open Response

The following questions are optional and help us understand how best to support you. This form is not monitored in real time and does not replace emergency care. If you are in immediate danger, please contact local emergency services or the Suicide & Crisis Lifeline (U.S. 988).