1. Medical Needs

* 1. Are you able to afford all the medication you need?

* 2. If no, do you receive assistance from any of the following? (choose all that apply).

* 3. Do you have transportation to and from medical appointments?

* 4. Who provides your transportation?

* 5. Are you currently the primary caregiver for someone with illness or disability?

* 6. Do you have access to services that assist you with caregiving?

* 7. What caregiving services would you access if they were available? (choose all that apply)

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