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* 1. When would you be more likely to ulitize services? You may mark multiple options.

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* 2. Do you have an interest for Adult Day Health Services to be opened on Saturday?

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* 3. When would you most likely attend an educational or support group?

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* 4. Would you be more likely to attend a support group if we offered on-site respite for the person you are caring for?

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* 5. Would you be willing to pay for respite services while attending a class?

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* 6. What do you consider a reasonable hourly rate that you would pay to care for your loved ones?

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* 7. What additional services could Wilder Foundation Community Services for Aging offer?

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* 8. How can we improve our services?

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* 9. Other comments:

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