2022 16th Annual Statewide Caregiver’s Conference Survey

The 16th Annual Statewide Caregivers Conference is scheduled for November 9, 2022. The Conference Planning Committee is reaching out to prospective attendees to gain an understanding of their willingness to attend either a virtual or in-person conference.

Thank you for taking the time to complete this survey.

Question Title

* 1. Contact information

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. I am a:

Family Caregiver

Professional Caregiver

Other (please specify)

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* 3. The age of the person I support is:

Birth to 21

22-40

41-60

61-80

81+

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* 4. Due to your caregiving responsibilities during the COVID-19 Pandemic are you still isolating yourself and the person that you are providing care to?

Yes

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* 5. How often have you attended the Annual Statewide Caregiver’s Conference in the past?

Always

Usually/often

Sometimes/occasionally

Rarely/seldom

Never

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* 6. For this year (2022) which conference format will suit your caregiver needs?

in-person

virtually

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* 7. What specific information/topic could we provide at the conference to help you as a caregiver?

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* 8. How important is having the opportunity to network with others during the conference?

Extremely important

Very important

important

Not so important

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* 9. How important are opportunities for rejuvenation/self-care during the conference (i.e.: Massage, Reiki, Seva)?

Extremely important

Very important

important

Not so important

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* 10. Do you have any local or national speakers to recommend?

Yes

2022 16th Annual Statewide Caregiver’s Conference Survey

Question Title

* 1. Contact information

Question Title

* 2. I am a:

Question Title

* 3. The age of the person I support is:

Question Title

* 4. Due to your caregiving responsibilities during the COVID-19 Pandemic are you still isolating yourself and the person that you are providing care to?

Question Title

* 5. How often have you attended the Annual Statewide Caregiver’s Conference in the past?

Question Title

* 6. For this year (2022) which conference format will suit your caregiver needs?

Question Title

* 7. What specific information/topic could we provide at the conference to help you as a caregiver?

Question Title

* 8. How important is having the opportunity to network with others during the conference?

Question Title

* 9. How important are opportunities for rejuvenation/self-care during the conference (i.e.: Massage, Reiki, Seva)?

Question Title

* 10. Do you have any local or national speakers to recommend?

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* 11. Name of speaker you have had experience with and their expertise or topic:

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* 12. Additional comments: