Grace Center’s mission is to provide day services that optimize the cognitive and physical abilities of seniors and adults with disabilities so they can remain as independent as possible and in their homes.

Welcome to the Grace Center Survey

Thank you for taking the time to complete this survey. Your feedback is important.

Question Title

* 1. (Optional) Contact Information

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Primary Phone Number

Question Title

* 2. (Optional) What age category do you fall into?

20-29

30-39

40-49

50-59

60-69

70-79

80+

Question Title

* 3. How did you first become connected with Grace Center?

Family member/friend 

Utilized our services

Attended Grace Center’s Open House 

Referred to Grace Center

Attended the annual Aging Summit 

A Grace Center staff member/volunteer

Other (please specify)

Question Title

* 4. Of our program and services, your gifts help support, what are the most important to you?

Memory Care Specialty: providing a safe, stimulating environment for participants at every stage of memory loss

Post-rehabilitation Specialty: offering participants the support & equipment needed to continue rehabilitation

Respite for family caregivers: a break for family caregivers so they can continue caring for their loved ones

Health Monitoring: care provided by our nurse & dedicated staff to meet participants’ needs (i.e. assistance with activities of daily living, medication management, individualized plans of care)

Socialization/Exercise: a robust activities program & daily exercise regimen

Question Title

* 5. Please tell us in your own words, why you choose to donate to Grace Center?

Question Title

* 6. To what extent do you feel your donations and volunteer work has impacted the community and the people we serve?

Great difference 

Moderate difference 

Little difference

Question Title

* 7. How well does our organization communicate?

Not very well

Moderately well

Very well

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 8. How could Grace Center improve on communication?

Question Title

* 9. How often do you want to hear from Grace Center about organization updates?

Monthly 

Every other month 

Quarterly

Question Title

* 10. How do you prefer to be contacted? (check all that apply)

Phone 

Email 

Mail

Text (please enter cell phone number below)

Question Title

* 11. How do you prefer to give?

Gift by cash or check 

Gift from an IRA/retirement account 

Gift in your will

Gift by credit card 

Gifts of stocks or real estate 

Through volunteering

Other (please specify)