* 1. What is you age group?

* 2. Please identify your preferred FOOD SHOPPING DESTINATION

* 3. Please identify the Hospital/Outpatient Care facility your primary care physician is affiliated with.

* 4. Please identify your preferred Pharmacy

* 5. Please identify your preferred RETAIL SHOPPING destinations.

* 6. Please identify your preferred Restaurants.

* 7. Would you use CART shuttle for employment purposes?

* 8. Do you attend regular community provided services (ie Meals on Wheels, Workshops, Educational Activities, Senior Center)

* 9. What days do you typically attend Town of Derry located or provided services (ie Meals Programs, Workshops, Educational)

* 10. What hours do you typically attend the above programs?

* 11. Would you like to have a regular connection to the Manchester / Boston Regional Airport?

* 12. Would you like to have a regular connection to the Mall of New Hampshire?

* 13. Would you like to have a regular connection to Boston Express Bus Service?

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