CCAAA Four Year Plan Survey

1. Tell us where you live:

Tell us where you live: City:
Township:
Borough:

2. Which category below includes your age?

Which category below includes your age? Under 60

60-64

65-69

70-74

75-79

80 or older

3. Do you currently attend or are you interested in attending any of our Senior Centers or Centers for Active Living in Clearfield County?

Do you currently attend or are you interested in attending any of our Senior Centers or Centers for Active Living in Clearfield County? Yes

4. Did you know the Agency helps protect elders from abuse, neglect, and financial exploitation?

Did you know the Agency helps protect elders from abuse, neglect, and financial exploitation? Yes

5. Rate your quality of life right now.

	Terrible	Poor	Ordinary	Good	Fantastic
Quality of Life	*Rate your quality of life right now. Quality of Life Terrible	Quality of Life Poor	Quality of Life Ordinary	Quality of Life Good	Quality of Life Fantastic

6. If you would like to receive our bi-monthly newsletter, Lifespan, via email, please enter your email address.

If you would like to receive our bi-monthly newsletter, Lifespan, via email, please enter your email address.

7. Please select all community services you think you will need in the next four years.

Please select all community services you think you will need in the next four years. Nutritious meals

Educational programs

Socialization & recreation

Health and wellness activities

Civic engagement

Transportation

8. Please select all in-home services you think you will need in the next four years.

Please select all in-home services you think you will need in the next four years. Personal emergency response

Help caring for a family member

Home Delivered Meals

Help with bathing, dressing, etc.

Nursing care in the home

Help keeping track of medications

Help cooking my own meals

Help doing housework

Help with yard work and house repairs

9. Please select all special services you think you will need in the next four years.

Please select all special services you think you will need in the next four years. Adult Day Care

Alzheimer's Support Group

Help getting employment

Health insurance counseling

Financial advice

Help paying for my prescription drugs

Medicare Part D counseling

Pennsylvania Property Tax/Rent Rebate Program

Help filing my annual income taxes

Protection from abuse, neglect, or financial exploitation

Retirement counseling

10. Are there any other services you think we should consider providing over the next four-year period or anything else you would like us to know?

Are there any other services you think we should consider providing over the next four-year period or anything else you would like us to know?

CCAAA Four Year Plan SurveyExit this survey