The Alameda County Council for Age-Friendly Communities* is conducting a brief survey of older adults in our County to determine gaps in access to the internet and electronic devices, and the need for education and support to use those devices. Your responses to this survey are confidential and will help us find that information.

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* 1. Please provide your Zip Code:

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* 2. Are you able to access the internet at least once per week?

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* 3. If yes, where do you currently access the Internet or go online? (Check all that apply)

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* 5. Please indicate below whether or not you are comfortable with the following tasks.

  Yes No
Doing an internet or Google search.
Using an email account to connect to people and/or online services (send messages, photos, etc.)
Using video applications such as Zoom, FaceTime, WhatsApp, YouTube, or other options.
Accessing benefits such as CalFresh, housing, insurance, or other community resources.
Shopping online for medication, clothes, groceries, etc.
Banking online such as paying bills, checking account balances and credit card statements, etc.
Using voice-activated features such as on Alexa or Google Home, or on a smartphone.
Having a telehealth meeting with a doctor or other healthcare provider.
Using social media such as Facebook, Instagram, Twitter, etc.

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* 6. Please specify any other tasks you do with your computer, tablet and/or smartphone:

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* 7. Is there anyone else in your home who can assist you in doing any of these tasks?

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* 8. Do you have any special needs that would affect the type of device you could use such as larger font, larger keyboards or screens, voice-activated software, etc.?   

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* 9. What are your preferred learning methods? (check all that apply)

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* 10. What is your age group?

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* 11. What is your gender? How do you self-identify? (Write "Prefer not to State" if you would prefer not to answer this question)

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* 12. What is your sexual orientation? (Check all that apply)

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* 13. What is your race or ethnicity? (Check all that apply)

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* 14. What is your household's monthly income?

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* 15. What is your preferred language? (Write "Prefer not to State" if you would prefer not to answer this question)

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* 16. How many people are in your household, including yourself? (Write "Prefer not to State" if you would prefer not to answer this question)

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* 17. Do you have any comments for us?

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* 18. (Optional) Please provide your name and email address or phone number if you would like us to be able to contact you in the future about digital resources, if available.

*The Alameda County Council for Age Friendly Communities coordinates efforts to effect policy and system changes that enhance the overall well-being of older adults who live in Alameda County, engaging leaders, consumers, and providers to develop and sustain a community framework that fosters healthy aging. The Council is a forum for expanding resources, services, and access to services and increasing collaboration among many stakeholders, including County departments, cities, and Community Based Organizations (CBOs). Please visit agefriendly.acgov.org/af-efforts/af-council for additional information.

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* 19. ALAMEDA COUNTY PUBLIC HEALTH USE ONLY: Survey Code

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