Thank you for your interest in getting involved in making Cleveland Heights dementia-inclusive! Please complete the questions below.

If you have any questions, please contact Sarah Nicolay, research assistant at Benjamin Rose Institute on Aging, at snicolay@benrose.org

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* 1. What is your name?

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* 2. What is your organization?

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* 3. What is your job title?

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* 4. What is your email address?

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* 5. Which sector of the community are you/your organization a part of?

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* 6. Are you interested in scheduling a Dementia Friends session for you/your organization?

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