2019-2021 County Plan on Aging Survey

Are you an older adult? Are you a family caregiver?

Let your voice be heard! Your opinion counts.

Your County Aging & Disability Resource Center (ADRC) or Health and Human Services Department is in the process of capturing views, concerns and issues facing County residents 60 years and older plus family caregivers in preparation of drafting the 2019-2021 County Plan on Aging for the County. The County Plan on Aging depicts how the County will spend federal and state Older Americans Act funding for aging programs. To fulfill our mission in drafting the County Plan on Aging, we ask for input from older adults and family caregivers.

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* 1. County of Residence:

Calumet

Fond du Lac

Green Lake

Marquette

Menominee

Outagamie

Shawano

Waupaca

Waushara

Winnebago

Other (please specify)

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* 2. Please list what you feel are the three (3) most important issues you are facing?

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* 3. Are there programs or services you wish were available in your community?

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* 4. Other additional thoughts or comments?

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* 5. Contact Information (Optional)

Name

Telephone

Thank you for taking this survey and providing us with this valuable input!