Appendix C1. CFR Follow-Up Survey
Landing Page
Welcome to the Follow-Up Survey for the Coaching for Resilience Program
This is the follow-up Coaching for Resilience (CFR) evaluation survey (you completed the baseline survey approximately four months ago as a trainee). The DoD has contracted NORC at the University of Chicago (NORC) to support an independent evaluation of the CFR program. NORC is a non-partisan, objective research institute that provides rigorous and reliable research and evaluation services to clients.
The evaluation survey should take about 15 minutes to complete. We need the baseline evaluation participants to complete this follow-up survey! When you complete the survey, you will receive a $30 e-gift card as a thank you for your time. If you choose to volunteer for a follow-up interview with NORC and are selected, you will receive an additional $40 e-gift card.
Your contact information is stored separately from your survey responses. NORC will not share individual survey responses with the Army or DoD.
This survey is confidential. Your responses will be linked to a unique ID, which cannot be linked back to you. Your responses will be combined with others, and the results will be reported in aggregate. This survey is voluntary. You may skip any questions or stop the questionnaire at any time without penalty.
If you have any questions about this survey or the evaluation being conducted by NORC, please contact the NORC Project Team by email: ArmyResilience@norc.org.
OMB CONTROL NUMBER: 0704-0644
OMB EXPIRATION DATE: 01/31/2026
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0704-0644, is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.
Privacy Advisory: Personal contact information is being collected and used by the NORC at the University of Chicago (NORC) for the purpose of distributing gift cards in thanks for your participation and to contact you for the optional follow-up CFR evaluation interview. Your information will be securely stored by NORC, will not be delivered to DoD for any non-stated purpose, and will be destroyed no later than September 28, 2027, at the conclusion of NORC’s contract. Providing your information is voluntary, however, choosing not to provide your personal contact information will result in NORC’s inability to offer the $30 gift card as a thank you for your participation today, and exclusion from the optional follow-up evaluation interview and the subsequent $40 gift card for participation in the follow-up evaluation interview.
Experience with Coaching
Do you recall participating in one-on-one coaching sessions with an Army Performance Expert as part of the Coaching for Resilience (CFR) program, about three months ago during OSUT?
Yes
No
Not sure
Army Performance Experts (PEs) were assigned to meet with soldiers for 4 CFR sessions. Some soldiers may have met with the same PE for all sessions. Other soldiers may have seen different PEs for their sessions. How many PEs did you meet with for your coaching sessions?
1
More than 1
I do not remember
Additional Constructs for CFR Pilot Evaluation
SELF-AWARENESS/CONFIDENCE
3. Self-Efficacy
How strongly do you agree or disagree with these statements: |
Strongly Disagree |
Disagree |
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Agree |
Strongly Agree |
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4. Help-Seeking Behaviors
Imagine that you begin to experience some problem. The problem is not so overwhelming that you can’t function. However, it continues for more than a few days. You consider seeking help from someone. Below are several reasons why you might choose NOT to seek help. Please read each reason and decide how important it would be in keeping you from seeking help.
How strongly do you agree or disagree with these statements: |
Strongly Disagree |
Disagree |
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Agree |
Strongly Agree |
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5. Help-Seeking Attitudes
How strongly do you agree or disagree with these statements: |
Strongly Disagree |
Disagree |
Agree |
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6. Retention to the Military
How strongly do you agree or disagree with these statements: |
Strongly Disagree |
Disagree |
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Agree |
Strongly Agree |
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How strongly do you agree or disagree with these statements: |
Strongly Disagree |
Disagree |
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Agree |
Strongly Agree |
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HEALTH STATUS
8. Mental Health
How much of the time, during the last month, have you |
All of the time |
Most of the time |
A good bit of the time |
Some of the time |
A little of the time |
None of the time |
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Initial Entry Training – Individual Resilience Assessment
Please rate how often you use the following strategies when coping with stressful situations: |
Never |
Almost never |
Sometimes |
Fairly often |
Very often |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Listed below are some strategies for coping with stressful situations. For questions 1, 2, and 3, please select the three coping strategies you use most often to cope with stressful situations.
Please select the FIRST most often used strategy, then the SECOND, and finally, the THIRD most often used strategy for coping successfully with a stressful situation. Mark only one for each.
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a |
b |
c |
d |
e |
f |
g |
h |
i |
j |
1. FIRST |
O |
O |
O |
O |
O |
O |
O |
O |
O |
O |
2. SECOND |
O |
O |
O |
O |
O |
O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
O |
O |
O |
O |
O |
Please indicate the extent to which the following statements describe you: |
Not at all |
Slight extent |
Moderate extent |
Great extent |
Very great extent |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
In the last month, how often have you... |
Never |
Almost never |
Sometimes |
Fairly often |
Very often |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please indicate how much you agree or disagree with the following statements: |
Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |
Strongly agree |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please indicate the extent to which you agree or disagree with the following statements about your current military life: |
Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |
Strongly Agree |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please rate how often you use the following strategies when dealing with a conflict: |
Never |
Almost never |
Sometimes |
Fairly often |
Very often |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please indicate the extent to which the following statements describe you: |
Not at all |
Slight extent |
Moderate extent |
Great extent |
Very great extent |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please indicate the extent to which the following statements describe you: |
Not at all |
Slight extent |
Moderate extent |
Great extent |
Very great extent |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please indicate the extent to which the following statements describe you: |
Not at all |
Slight extent |
Moderate extent |
Great extent |
Very great extent |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
Please indicate the extent to which the following statements describe you: |
Not at all |
Slight extent |
Moderate extent |
Great extent |
Very great extent |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
18. Social Determinants of Health
Regarding your life prior to entering the military, please indicate how much you agree or disagree with the following statements: |
Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |
Strongly agree |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
O |
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O |
O |
O |
O |
Contact Information Page and Thank You Page
Thank you for your time and response today
Key-Informant Interview Volunteer
NORC is conducting interviews (45 minutes) with Soldiers about their experience participating in the Army’s Coaching for Resilience program. If you are interested and willing to participate in an interview, please indicate below. Your participation and responses shared in an interview with NORC will be kept confidential; NORC will not share names or identifying characteristics of participating Soldiers with the USA or the DoD. Your input will be invaluable for informing improvements to CFR. You will receive a $40 electronic gift card if you are selected to participate in an interview.
I do not volunteer to participate in a brief follow-up interview with NORC [Skip to incentives]
I volunteer to participate in a brief follow-up interview with NORC.
Please provide your information to be contacted by the NORC research team for the brief interview. Your email address will not be linked with any of your answers to the questions in this survey. Your email address will not be shared with anyone in your Army unit or chain of command or in the DoD. NORC will solely use this information for communications about this evaluation effort.
Last Name: ________
Personal Email Address:________
To allow NORC to text you with information regarding the follow-up interview, please enter your cell phone number below:
Enter area code and phone number with no dashes _____________
By providing this number, you allow NORC to text you using an automated text system. We will only use your phone number for TILT evaluation purposes. NORC will not share, sell, or otherwise use this number. You can reply STOP to our text messages to opt out at any time. Reply HELP for help. Standard messaging and data rates may apply. Message frequency may vary.
Is the below information correct? If any piece of the below information is incorrect, select “No, I need to make a correction.”
Name: [LNAME]
Personal Email:[PER_EMAIL]
Cell Phone: [CELL]
Yes, all information is correct
No, need to make a correction
Please edit your responses below to update the information, then hit “Next.”
Name: [LNAME]
Personal Email:[PER_EMAIL]
Cell Phone: [CELL]
Click Next to get your $30 e-gift card.
Incentives Contact Information
We would like to confirm your contact information to send you your $30 e-gift card. Your contact information will not be linked with any of your responses provided today, or used for any non-stated purpose. Your contact information will not be shared with anyone in your Army unit or chain of command or in the DoD. NORC will only use this information for communications about this evaluation effort. Please click “Next” if you do not wish to receive your gift code.
NORC WILL CONFIRM WITH NORC IT PROGRAMMERS IF WE CAN USE INFORMATION THAT PARTICIPANT PROVIDED ABOVE (WHILE ALLOWING PARTICIPANT TO HAVE A DIFFERENT EMAIL FOR THEIR INCENTIVE THAN FOR THEIR INTERVIEW CONTACT.)
Last Name: ________
Personal Email:_________
Is the below information correct? If any piece of the below information is incorrect, select “No, I need to make a correction.”
Last Name: [LNAME]
Personal Email:[PER_EMAIL]
Yes, all information is correct
No, need to make a correction
Please edit your responses below to update the information, then hit “Next.”
Last Name: __ [LNAME] ____
Personal Email: __ [PER_EMAIL]____
Thank you
Thank you for participating in the baseline evaluation survey of the Coaching for Resilience program! NORC will send you your $30 e-gift code to your preferred email address.
If you volunteered to participate in an interview with NORC, please look for an email from ArmyResilience@norc.org with a link to schedule your interview.
If you have any questions, please contact NORC at ArmyResilience@norc.org.
National Resources for Soldiers
Suicide or Self-Harm
Suicide
Prevention Lifeline
TOLL-FREE: 988
This
crisis lifeline provides 24/7 confidential support (via text, call,
or chat) and help if you are feeling mental health struggles,
emotional distress, depression, substance abuse concerns, and/or
thoughts about suicide. Judgement-free counselors are available to
provide immediate support.
Domestic Violence
National
Domestic Violence Hotline
TOLL-FREE: 1-800-799-7233 or TTY
This
hotline provides 24/7 support (via text, call, or chat) to talk
confidentially if you are experiencing domestic violence, seeking
resources or information, or questioning unhealthy aspects of your
relationship.
National
Network to End Domestic Violence (NNEDV)-Safety Net
Project
techsafety.org
This
website provides resources and information on the use of technology
for agencies and survivors of domestic violence, sexual assault,
stalking, and trafficking. These include survivor, agency, app safety
center, confidentiality, and legal systems toolkits.
National
Network to End Domestic Violence (NNEDV)
womenslaw.org
or womenslaw.org/es (Español), Email Hotline:
hotline.womenslaw.org/public
This website provides information
relevant to anyone with questions about domestic violence, sexual
violence, and other relevant topics. The email hotline site will
provide legal information to anyone, not just women, who reaches out
with legal questions or concerns regarding these topics.
Love
is Respect, National Dating Abuse Helpline
TOLL-FREE:
1-866-331-9474
TEXT:
‘LOVEIS’ to 22522
This
support line provides 24/7 assistance and help if you or someone you
know is in an unhealthy or unsafe dating relationship, no matter how
casual, or if you want to know more about personal safety and healthy
relationships. Call center support is offered via text, call, or
chat.
Sexual Assault
National
Sexual Assault Hotline
TOLL-FREE: 1-800-656-HOPE
(4673)
hotline.rainn.org/online
(Español) hotline.rainn.org/es
This hotline connects you to a trained staff member from a sexual assault service provider in your area. The staff member can provide confidential support (via online chat or call) in finding local resources, such as referrals for long-term support and information about the laws in your community. You can also access 24/7 help online by visiting https://hotline.rainn.org/online.
The Rape, Abuse, Incest National Network (RAINN) is a partnership of more than 1,100 local rape treatment hotlines that maintains an online referral resource directing you to local rape crisis centers nationwide.
Mental Health Services
SAMHSA’s
National Helpline
(Substance Abuse and Mental Health Services
Administration)
TOLL-FREE 1-800-662-HELP (4357)
SAMHSA’s
National Helpline is a free, confidential, 24/7, 365-day-a-year
treatment referral and information service (in English and Spanish)
for individuals and families facing mental and/or substance use
disorders.
NAMI
(National Alliance on Mental Illness)
HelpLine 1-800-950-NAMI
(6264)
The NAMI HelpLine is
a free, nationwide peer-support service providing information,
resource referrals, and support to people living with a mental health
condition, their family members and caregivers, mental health
providers, and the public. HelpLine staff and volunteers are
experienced, well-trained, and able to provide guidance. To contact
the NAMI HelpLine, call 800-950-NAMI (6264), Monday through Friday,
10 AM –8 PM ET, or email info@nami.org.
Victim Services
National
Center for Victims of Crime
TOLL-FREE: 1-855-4-VICTIM
(1-855-484-2846)
victimconnect.org
This website has information to help victims of crimes learn about their rights and options confidentially. It provides a phone-based helpline, an online chat tool, and web-based information and service referrals.
This hotline provides support and directs you to a state referral service for legal assistance or mental health care providers. They can also refer you to a local service provider who can provide more specific referrals. This number can be reached Monday-Friday from 12 PM-5 PM ET.
Stalking
Prevention and Awareness Resource Center
(SPARC)
stalkingawareness.org
SPARC
provides nationwide training, technical assistance, and resources to
allied professionals, including victim service providers, law
enforcement, prosecutors, court personnel, judges, corrections,
treatment providers, mental health professionals, campus student
conduct offices, campus police/security, Title IX offices, and
others.
National
Human Trafficking Hotline
TOLL-FREE: 1-888-373-7888
Text
“BeFree” (233733)
polarisproject.org
This
national hotline provides 24/7 support to answer calls, texts, and
live chats from anywhere in the United States in more than 200
languages. The National Hotline’s mission is to connect human
trafficking victims and survivors to critical support and services to
get help and stay safe and to equip the anti-trafficking community
with the tools to combat all forms of human trafficking effectively.
Digital or Media Victims Services
Nonconsensual
Pornography Hotline
TOLL-FREE: 1-844-878-CCRI (2274) Cyber Civil
Rights Initiative Helpline
This
hotline provides 24/7 support to victims of nonconsensual pornography
(“NCP”, also known as “revenge porn”),
recorded sexual assault (RSA), or sextortion. They can provide
information, support, referrals, and non-legal advice.
FAQ
Who is NORC at the University of Chicago?
NORC is a not-for-profit survey and research organization that is working with the U.S. Army and the DoD Sexual Assault Prevention and Response Office (SAPRO) to evaluate the Coaching for Resilience program currently being piloted at Ft. Leonard Wood. For more information about NORC, visit www.norc.org.
How do I know this form is confidential?
All survey responses will be stored separately from your PII – your name and email. PII is used to help us evaluate the CFR program while maintaining confidentiality. Your responses will be linked across the baseline and follow-up surveys to help us evaluate the CFR program. NORC will also use your contact information to deliver incentives and other survey-related communication.
How long will this survey take to complete?
The form will take about 15 minutes to complete.
Why should I participate?
The benefits to your participation may include better prevention programming and a more supportive environment for soldiers on base. The feedback provided in this survey will be used to better understand the experiences soldiers are having in the Army and will aid NORC’s evaluation of the CFR program.
Any immediate benefit to me?
You will receive a $30 e-gift card for completing this survey today.
Do I have to fill out this form?
No, you do not have to fill out the survey. It is voluntary, but in order to receive a $30 e-gift card, you must provide your information after completing the survey.
What is this survey about?
This survey is part of an evaluation of the CFR program. The goal of collecting this feedback is to better understand the experiences soldiers are having in the Army.
Technical Assistance
This survey is best viewed on a laptop, desktop, or large tablet running the current Firefox, Chrome, Safari, or Edge versions.
You can go forward or backward in the form by clicking the Next or Back buttons. (DO NOT use your browser’s Back or Forward buttons).
If you leave the survey idle for more than 10 minutes, it will time out to keep your responses confidential. Since the survey is confidential, you will need to log back into it with the link that was sent by ArmyResilience@norc.org to your email. All the responses you provided up until the survey timed out are saved.
For other technical support questions, or if you encounter any problems as you complete the survey, please contact NORC at ArmyResilience@norc.org. for assistance.
ETAC T1 CFR
Evaluation
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Shagun Patel |
| File Modified | 0000-00-00 |
| File Created | 2026-01-07 |