Community Needs Assessment

Introduction

This survey is anonymous, and you may choose to answer some or all of the questions provided. The answers given in the survey will be kept confidential and will only be used to inform projects toward creating a more dementia-friendly community in East Texas.

If you would like to learn more about the results of the survey and future projects, you will have the opportunity to leave your email address at the end of the survey. For questions, please call the Alzheimer's Alliance at (903) 509-8323.

Question Title

* Please choose one. (Each answer has a specific set of questions. You may take the survey multiple times in order to answer the questions for each of your roles.)

I am currently or have been a family caregiver for a person with Alzheimer's disease or dementia.

I am an owner or manager of a business or department.

I am employed by the local, county, state, or federal government.

I serve in health care or a health-related profession, such as a hospital, clinic, or home health provider.

I work in a residential care setting, such as an independent or assisted living community, nursing home, memory care, or hospice.

I am a member of a church, synagogue, mosque, temple, or other faith community.

I participate in or volunteer with a community association, club, nonprofit, or other organization.