Skip to content
Stress Survey
*
1.
Which age range describes you?
(Required.)
Under 18
18-24
25-34
35-44
45-54
55-64
65+
*
2.
Which of the following best describes you?
(Required.)
I am a senior who lives at home and receives help from a caregiver.
I am a senior who lives in a nursing home.
I have a parent who lives at home and receives help from a caregiver.
I have a parent who lives in a nursing home.
None of the above.
*
3.
My stress level regarding nursing homes is:
(Required.)
No stress
Extreme stress
Clear
*
4.
Explain your response to the previous question.
(Required.)
*
5.
My stress level regarding at-home caregivers is:
(Required.)
No stress
Extreme stress
Clear
*
6.
Explain your response to the previous question.
(Required.)
*
7.
What is your email address? Note: Your email address will only be used to enter you into the drawing to win prizes. You will be contacted via email if you win. Your email address will not be shared and all reports resulting from this survey will remain anonymous.
(Required.)
Current Progress,
0 of 7 answered