PLEASE NOTE: This survey is being used for data collection. CareSpotlight will not be following up with you individually regarding your answers. Please know that you are helping us to decipher what type of assistance people are seeking. If you include your email address, we will let you know when the website officially launches and at that time you will be able to connect to others, access information, etc. THANK YOU!
Are you currently a caregiver and/or advocate to a family member or friend who is aging; has a physical, developmental and/or intellectual disability; has been diagnosed with a serious mental illness; is chronically or terminally ill; or has been seriously injured?

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* 1. Are you currently a caregiver and/or advocate to a family member or friend who is aging; has a physical, developmental and/or intellectual disability; has been diagnosed with a serious mental illness; is chronically or terminally ill; or has been seriously injured?

If you answered "yes" to question #1, is that person your:

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* 2. If you answered "yes" to question #1, is that person your:

Please check all that apply:

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* 3. Please check all that apply:

If you are seeking care and/or services for yourself and/or your loved one, patient, client, etc., please indicate what type of provider you are seeking? Please check all that apply.

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* 4. If you are seeking care and/or services for yourself and/or your loved one, patient, client, etc., please indicate what type of provider you are seeking? Please check all that apply.

Please check ALL that apply:

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* 5. Please check ALL that apply:

Please check all that apply about reviewing care and/or service providers:

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* 6. Please check all that apply about reviewing care and/or service providers:

Please answer the following about connecting with others:

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* 7. Please answer the following about connecting with others:

Please select your gender:

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* 8. Please select your gender:

Please select your age range:

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* 9. Please select your age range:

PLEASE NOTE: You are only required to enter your CITY, STATE and ZIP CODE. Any additional information will be used for our records only. We will not share your information. CareSpotlight.com will ONLY be serving people in the Continental U.S. Information outside the Continental U.S. will not be used at this time. Thank you.

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* 10. PLEASE NOTE: You are only required to enter your CITY, STATE and ZIP CODE. Any additional information will be used for our records only. We will not share your information. CareSpotlight.com will ONLY be serving people in the Continental U.S. Information outside the Continental U.S. will not be used at this time. Thank you.

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