Form Center • Bexar County, TX • CivicEngage

1. How did you first learn that this program was an option for you?

2. Why did you originally choose to come into this program?

3. During the application process, how well was all the necessary information about program and expectations explained to you by the VTC Case Manager?

4. Do you feel the expectations and requirements of the VTC based on your contract between yourself and the District Attorney’s Office was fair?

5. During VTC CSO Orientation with your assigned Officer, how well was all the necessary information about program rules, regulations, and expectations explained to you?

6. Which aspects of the court supervision do you feel is helpful to you? (Please check ALL that you feel motivates you)

Positive interaction with the Judge
Phasing up
Rewards/Incentives for doing good reaching goals
Home visits
Allowing peers to be present during both incentives and sanctions during dockets
Increased Meetings with Court Staff
Detention/Jail or just knowing that there is option of the court for Detention/Jail

7. Which aspects of the court supervision do you feel is LESS helpful to you in motivating you? (Please check ALL that apply)

Positive interaction with the Judge
Phasing up
Rewards/Incentives for doing good reaching goals
Home visits
Allowing peers to be present during both incentives and sanctions during dockets
Increased Meetings with Court Staff
Detention/Jail or just knowing that there is option of the court for Detention/Jail

8. Prior to this program, have you been under the supervision of any of the following? (Please check ALL that apply)

9. Did you receive sanction(s) while in this program? (Please check ALL that apply)

Other (please specify)

10. Did you receive incentives while in this program?

Yes

No

If YES, what did you receive?

11. What difficulties/barriers have you experienced while in this program?

If other, please specify:

12. Did you receive any extra services from the community or help to overcome some of these barriers while in this program?

Yes

No

If YES, what did you receive?

13. Do you attend any community support groups outside of your VTC requirements?

If other, please specify:

14. What level of satisfaction did you have with the support from Judge Christian?

Optional Comments:

15. What level of satisfaction did you have with the support from the VTC Staff?

Optional Comments:

16. What level of satisfaction did you have with the support from your assigned Community Supervision Officer?

Optional Comments:

17. What level of satisfaction did you have with the support from your assigned Veterans Justice Outreach Coordinator?

Optional Comments:

18. What level of satisfaction did you have with the support from your assigned Mental Health Provider? (If assigned a VJO while in the program please mark Not Applicable)

Optional Comments:

19. If you are on Pretrial Diversion (TRK 1), at the time of your dismissal is sent to you, do you plan to work on having your case expunged?

Yes

No

If No, Why?:

20. In your opinion, what are YOU most proud of from your experiences in the VTC?

21. What comments and/or changes would you like us to know about or think about for the program?

22. Where did you attend treatment while in VTC? (Please check ALL that apply)

VA Medical Center for groups or individual therapy (please type which VA below)
VA Medical Center for psychiatry or mental health medication (please type which VA below)
Groups or individual therapy using Tricare or other health insurance
Psychiatry or mental health medication using Tricare or other health insurance
Crosspoint
Endeavors
Vet Center
Somewhere else

23. Was this the first time you attended any sort of mental health treatment?

Yes

No

If no, what other kinds of treatment had you attended? (Please check ALL that apply)

Inpatient/residential treatment for substance abuse
Inpatient/residential treatment for PSTD, depression, anxiety or another diagnosis
Outpatient groups for substance abuse
Outpatient groups for a non-substance abuse issue
Outpatient treatment for mental health medication
Individual/one-on-one mental health therapy
AA or Al-Anon
Another peer support group (PTSD Foundation, Wounded Warrior Project, etc)
Other

Where did you receive that treatment:

If other – please explain:

24. How easy was it to arrange treatment upon entering the program?

Please explain what happened:

25. What type of treatment did you attend? (Please check ALL that apply)

Inpatient/residential treatment for substance abuse
Inpatient/residential treatment for PSTD, depression, anxiety or another issue
Outpatient groups for substance abuse
Outpatient groups for a non-substance abuse issue
Outpatient treatment for mental health medication
Individual/one-on-one mental health therapy
AA or Al-Anon
Another peer support group (PTSD Foundation, Wounded Warrior Project, etc)
Other

Please explain:

26. How helpful was your treatment experience in creating positive change in your life?

Please elaborate:

27. Did you find you were you able to apply treatment concepts to your everyday life?

Yes

No

If yes, explain how:

If no, what barriers stood in your way?

28. Do you continue to use the skills you learned in therapy today?

Yes

No

If yes, explain how:

If no, what barriers stood in your way?

29. Do you continue to attend some form of treatment, aftercare, peer support treatment, or utilize a sobriety sponsor currently?

Yes

No

Please share what you are participating in:

30. What, if anything, would you recommend your treatment provider/facility during VTC keep doing in the future? Please type your response.

31. What, if anything, would you recommend your treatment provider/facility during VTC stop doing in the future? Please type your response.

32. In what way(s) could your contact with your Veteran’s Justice Outreach Coordinator been better? (Please check ALL that apply)

More or less contact with VJO
VJO should have met with me mid-way through to review my treatment plan again
I would have liked for my VJO to assist me with more psychosocial issues not related to VTC
Nothing, I am satisfied with my contact with my VJO

Please explain why:

33. Upon admission to VTC, I felt that I needed the recommended treatment.

True

False

34. Today, I feel that I needed the treatment I received during VTC.

True

False

Bexar County Forms

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VTC Questionnaire

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Veterans Treatment Court Questionnaire

PART 1: VTC Questionnaire (34 Questions)

PART 2: Quality of Life Questionnaire (16 Questions)

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