Seniors: What do you need? TELL US A LITTLE BIT ABOUT YOU.

4Korners is currently conducting a needs assessment to better understand the needs of people who consider themselves to be seniors.  The video provides this same information, so feel free to answer the questions without viewing the video.

(Si vous préférez faire ce sondage en français, veuillez cliquer ICI.)

We would like to have an understanding of all needs you may have, specifically in relation to health, social services and other related services offered in your area. The purpose of this survey is to determine whether the existing services offered in the Laurentians (from all over the Laurentians: St-Eustache to Mont-Laurier and Rosemere to Oka, passing through Lachute and Brownsburg, on the way to Morin Heights and Rivière Rouge) meet the needs of the English speaking community.

Any information we get during the survey will be kept strictly confidential and only authorized personnel at 4Korners will have access to it.
 
We will begin by learning about you, then see if you know about programs offered in English, in your area. We will finish by understanding what your needs are now and what you anticipate them to be in the future.
 
We thank you in advance for helping us with this survey. We do not think it should take more than 35-45 minutes.

If you would like help completing the survey, please call 450-974-3940.

Please note, if you have already completed the survey, there is no need to do it again. Thank you so much!

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* 1. How did you hear about this survey?

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* 2. How old are you?

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* 3. Are you:

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* 4. Are you:

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* 5. What are the first three digits of your postal code of your home in the Laurentians? For example: J7R

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* 6. How many months of the year do you spend at this address?

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* 7. How many people live with you most of the year at this address?

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* 8. What was the first language you learned as a child?

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* 9. Which official language do speak best?

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* 10. Do you consider yourself to be bilingual (ENGLISH-FRENCH)?

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* 11. In general, would you say your physical health is:

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* 12. In general, would you say your mental health is:

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* 13. In general, would you say your spiritual health is:

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* 14. What is your household annual income?

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* 15. What is the highest level of education you have completed?

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* 16. Are you currently employed ?

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* 17. Do you have access to the internet?

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