Exit Members/Participants: Returning to Senior Center Survey Question Title * 1. Identify your age category 54 or below 55-65 66-74 75-84 85-95 96+ Question Title * 2. How has the COVID-19 pandemic affected you personally, including emotional, social, or physical health or financial impact?This information is important in helping us identify possible support services to offer our community. All answers are anonymous and confidential. Question Title * 3. How comfortable are you with resuming in-person classes and services? I'm very comfortable I'm somewhat comfortable Don't feel comfortable resuming in-person classes yet Something else (please specify) Question Title * 4. Given County guidelines and knowing health measures would be enforced, when do you think you will feel comfortable returning to the Center? Late Spring 2021 (April/May) Early Summer 2021 (June/July) Late Summer 2021 (August/September) Fall 2021 (October-November) Winter 2021/2022 (December-January) I'm not sure yet Something else (please specify) Question Title * 5. Would you be willing to be vaccinated if the Senior Center were to require proof of vaccination before attending in person classes or services? Yes No I have already received my vaccine. Prefer not to answer. Something else (please specify) Question Title * 6. If the Senior Center followed all CDC and Dept. of Public Health guidelines regarding masks, social distancing, hand sanitizing, etc. would you have additional considerations for yourself or others? Requiring all participants to verify their vaccination prior to participating (they will still have the option of participating virtually). Requiring all volunteers and instructors are vaccinated. Requiring participants to sign a contact tracing verification to notify you if you have been in close contact with someone who is diagnosed with coronavirus Nothing would make me feel comfortable resuming in-person classes Something else (please specify) Question Title * 7. Which classes are most important to you to resume in person? (check all that apply.) Exercise/Fitness Classes On-site lunches Educational lectures Support Groups Card games (poker, mahjong, etc.) Writing groups Foot care services Hair Cuts Blood pressure/glucose screenings Assistance/Support: Medicare help, LegalAid, etc. Something else (please specify) Question Title * 8. Please tell us more about your access to internet/virtual classes from home. I do not have access to internet at home because I am not interested. I do not have access to internet at home because I cannot afford it. I have limited access to internet at home and cannot participate in virtual classes. I do not have a device that allows me to connect to virtual classes. I have internet, but need training on how to access virtual classes. I have internet and am comfortable using my computer or other device. Something else (please specify) Question Title * 9. Have you participated in any Senior Center virtual class/activity? No Yes If no, please tell us why not. Question Title * 10. Would you like to have a choice whether to attend a class either virtually and/or in-person? (hybrid classes?) No Yes Other (please specify) Question Title * 11. Would you be willing to attend a class outside (in the garage or on the back porch?) No Yes Other (please specify) Question Title * 12. Should we have follow up questions or information, please provide your name and contact information (optional). First and Last Name: Email Address: Phone: Question Title * 13. Would you like to receive our weekly email updates (please note: an email address is required) Yes I'd like to receive email updates. No thank you, I'd rather not stay up to date with Senior Center news. Question Title * 14. Do you have any other comments, questions, or concerns? Done