Lifelong Mableton 2 Survey

1. Do you live in Mableton?

Do you live in Mableton? Yes

No

2. Do you think you’ll be able to or desire to continue living in South Cobb as you age?

Do you think you’ll be able to or desire to continue living in South Cobb as you age? Yes

No

I don't know

3. How old are you?

How old are you? > 21

21-54

55-65

66 +

4. Does Mableton do a good job of addressing the needs of its citizens in regards to:

	Yes	No	I don't know
Transportation	*Does Mableton do a good job of addressing the needs of its citizens in regards to: Transportation Yes	Transportation No	Transportation I don't know
Housing	Housing Yes	Housing No	Housing I don't know
Healthcare	Healthcare Yes	Healthcare No	Healthcare I don't know
Other Services	Other Services Yes	Other Services No	Other Services I don't know

5. Do you have multiple opportunties to be engaged in community activities, visit with neighbors, family and friends?

Do you have multiple opportunties to be engaged in community activities, visit with neighbors, family and friends? Yes

No

6. I can get to the services I require by:

	Personal Vehicle	Bus	CCT Paratransit	Cobb Senior Service Transportation	Walking	Driven by a friend
Doctors office	*I can get to the services I require by: Doctors office Personal Vehicle	Doctors office Bus	Doctors office CCT Paratransit	Doctors office Cobb Senior Service Transportation	Doctors office Walking	Doctors office Driven by a friend
Grocery Store	Grocery Store Personal Vehicle	Grocery Store Bus	Grocery Store CCT Paratransit	Grocery Store Cobb Senior Service Transportation	Grocery Store Walking	Grocery Store Driven by a friend
Social engagements	Social engagements Personal Vehicle	Social engagements Bus	Social engagements CCT Paratransit	Social engagements Cobb Senior Service Transportation	Social engagements Walking	Social engagements Driven by a friend
Church services and functions	Church services and functions Personal Vehicle	Church services and functions Bus	Church services and functions CCT Paratransit	Church services and functions Cobb Senior Service Transportation	Church services and functions Walking	Church services and functions Driven by a friend
Pharmacy	Pharmacy Personal Vehicle	Pharmacy Bus	Pharmacy CCT Paratransit	Pharmacy Cobb Senior Service Transportation	Pharmacy Walking	Pharmacy Driven by a friend
Shopping	Shopping Personal Vehicle	Shopping Bus	Shopping CCT Paratransit	Shopping Cobb Senior Service Transportation	Shopping Walking	Shopping Driven by a friend
Volunteer opportunities	Volunteer opportunities Personal Vehicle	Volunteer opportunities Bus	Volunteer opportunities CCT Paratransit	Volunteer opportunities Cobb Senior Service Transportation	Volunteer opportunities Walking	Volunteer opportunities Driven by a friend
Work	Work Personal Vehicle	Work Bus	Work CCT Paratransit	Work Cobb Senior Service Transportation	Work Walking	Work Driven by a friend

7. I consider myself to be active in my community.

I consider myself to be active in my community. Yes

No

8. I routinely participate in:

I routinely participate in: Church Events

Classes

Volunteer Activities

Civic Activities

Governmental Affairs

Children's Activities

Older Adult Activities

Arts and Cultural Activities

Health and Wellness Activities

Exercise classes

9. Are there housing options in your community that will allow you to move to a smaller, more manageable home if and when necessary or desireable?

Are there housing options in your community that will allow you to move to a smaller, more manageable home if and when necessary or desireable? Yes

No

10. Please enter your contact information if you would like to receive updates about the Lifelong Mableton Initiative or if you would like to participate in an aspect of the Initiative.

Please enter your contact information if you would like to receive updates about the Lifelong Mableton Initiative or if you would like to participate in an aspect of the Initiative. Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP:
Country:
Email Address:
Phone Number:

Lifelong Mableton 2
Exit this survey

1. Default Section

1. Do you live in Mableton?

2. Do you think you’ll be able to or desire to continue living in South Cobb as you age?

3. How old are you?

4. Does Mableton do a good job of addressing the needs of its citizens in regards to:

5. Do you have multiple opportunties to be engaged in community activities, visit with neighbors, family and friends?

6. I can get to the services I require by:

7. I consider myself to be active in my community.

8. I routinely participate in:

9. Are there housing options in your community that will allow you to move to a smaller, more manageable home if and when necessary or desireable?

10. Please enter your contact information if you would like to receive updates about the Lifelong Mableton Initiative or if you would like to participate in an aspect of the Initiative.

Lifelong Mableton 2Exit this survey

1. Default Section

1. Do you live in Mableton?

2. Do you think you’ll be able to or desire to continue living in South Cobb as you age?

3. How old are you?

4. Does Mableton do a good job of addressing the needs of its citizens in regards to:

5. Do you have multiple opportunties to be engaged in community activities, visit with neighbors, family and friends?

6. I can get to the services I require by:

7. I consider myself to be active in my community.

8. I routinely participate in:

9. Are there housing options in your community that will allow you to move to a smaller, more manageable home if and when necessary or desireable?

10. Please enter your contact information if you would like to receive updates about the Lifelong Mableton Initiative or if you would like to participate in an aspect of the Initiative.

Lifelong Mableton 2
Exit this survey