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1. How long have you lived in Dunedin?

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2. Please share your gender.

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3. Please select your age group from the following choices.

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4. Which of the following best describes your current marital status?

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5. Please select the following that best describes your current living situation.

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6. How often do you worry about having enough money for basic needs?

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7. Are you currently employed? Please check the most appropriate boxes.

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8. How often have you felt food insecure in the last 12 months? Food insecurity is a condition where access to enough food for a healthy life is limited or uncertain.

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9. How often have you felt health care insecure in the last 12 months? Health care insecurity is feeling uncertain, anxious, and vulnerable about the ability to obtain or sustain adequate health care services.

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10. Please rate your frequency of use of the following communication devices.

  Never Infrequently (less than once a day) Regularly (at least once a day) Frequently (two to four times a day) Very frequently (five or more times a day)
Land line phone
Mobile/Smart phone
Tablet/iPad
Computer (desktop or laptop)

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11. Please indicate your use of the following computer applications. If you do not use computers, tablets or Smart Phones you can skip this question. (Check those you use more than four (4) times a month.

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12. Please indicate your use any of the following news and information sources. (Check those you use more than four (4) times a month.)

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13. Please rank your use of each of the following forms of transportation. (Check those you use and skip the rest.)

  Rarely (less than once a month) Infrequently (more than once a week but less than every day) Frequently (at least once a day) Very frequently (more than once a day)
Personal vehicle
Ride services (Uber, Lyft or taxi)
Public Transportation (buses, Jolly trolly, Freebee etc)
Rides from friends or family
Bicycle or walk
Other

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14. How often do you connect with friends and neighbors' or family members that do not live with you?

  Friends or neighbors Family members
Very Frequently (5 or more times per week)
Frequently (weekly)
Occasionally (1 to 4 times per month)
Infrequently (a few times a year)
Never

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15. How often do you feel stressed or overwhelmed?

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16. If you're feeling stressed or facing a challenging issue, who do you reach out to for advice and/or comfort? (Answer only those that apply to you.)

  Never Infrequently Frequently Very frequently
Spouse
Immediate family (Other than spouse)
Friends and/or neighbors
Faith leader
Physician
Other

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17. Below is a list of activities or associations. Please select your frequency of participation with each. (Check those you use and skip the rest.)

  Infrequently (1 to 4 times a year) Seldomly (5 to 12 times a year) Occasionally (12 to 23 times a years) Frequently (24 to 48 times a year) Very frequently (49 or more times a year)
Faith based organization
Service or social club
Educational classes
Exercise classes
Civic or City organizations
Bar or pub
Other

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18. From time to time everyone feels lonely or left out. Please indicate below the frequency you experience those feelings.

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19. How frequently do health issues limit your ability to leave your residence?

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20. Below is a list of facilities in Dunedin. Please select your frequency of use for each in the last year. (Check those you use and skip the rest.)

  Very Frequently (More than 50 times last year) Frequently (24 to 50 times last year) Occasionally (12 to 23 times last year) Infrequently (1 to 11 times last year)
Dunedin Community Center
Hale Senior Center
Dunedin Swimming Pool
City Parks & Trails
Dunedin Golf Club
Honeymoon Island State Park
Other

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21. Please check the following activities that interest you. Skip those that do not.

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22. Would you like to be kept informed about community services and programs? If so, please list your preferred method of contact.

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23. How often in the last year have you served as a volunteer for civic or service organization?

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24. Please rate this survey.

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