Exit this survey Satisfaction with ARCH National Respite Locator Immediate Thank you for using the online ARCH National Respite Locator Service to search for respite providers or programs and/or for additional respite resources. We would very much appreciate it if you could take just a minute to respond to this short survey. It will help us make the respite locator more responsive to your needs. Question Title * 1. How useful was the Respite Locator Service overall? Extremely useful Very useful Useful Somewhat useful Not at all useful Question Title * 2. Please indicate which categories of information were useful? Respite Provider Lists Medicaid Waivers Other Public Funding Sources General Caregiving Resources State Contacts for More Information What other information would you like to see included in the Respite Locator Service? Question Title * 3. How user-friendly is the online Respite Locator Service? Extremely user-friendly Very user-friendly User-friendly Somewhat user-friendly Not at all user-friendly Question Title * 4. How many times have you used the National Respite Locator Service This is the first time 2-4 times More than 4 times Question Title * 5. How likely are you to use the Respite Locator Service again? Extremely likely Very likely Likely Somewhat likely Not at all likely Question Title * 6. How likely are you to recommend the Respite Locator Service to others? Extremely likely Very likely Likely Somewhat likely Not at all likely Question Title * 7. Are you a: Family Caregiver Care Recipient Other family member Neighbor or Friend Other (please specify) Question Title * 8. If you are not seeking respite for yourself, are you seeking respite information as a representative of: Respite Provider Lifespan Respite Program State Government Agency Local Government Agency Aging and Disability Resource Center State Respite Coalition Caregiver Coalition National Organization Private State disability or aging organization Community-based organization Faith-based organization Private insurance company Hospital or health care facility Veterans Affairs Caregiver Program Other (please specify) Question Title * 9. Please provide any additional feedback. Question Title * 10. Please let us know which city and state you are from. The remaining contact information is optional. If you would like us to get back to you to provide assistance, please provide your email address. Name: Company: Address: Address 2: City/Town: * State: * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Country: Email Address: If you would like to be added to our email list, please click here. Done