* 1. Which safety devices were installed in your home? Please list.

* 2. Have you had any falls in the bathroom in the past three months?

* 3. Have you had any other falls?

* 4. If you received bathroom devices, did they help prevent falls?

* 5. Did you receive a safety manual? (If you didn't receive one, please visit olhsa.org/olderadultservices to download one)

* 6. Has this program made you feel more secure and safer in your home?

* 7. Have these devices helped you feel less stressed in your home?

* 8. Do you have an increased feeling of independence?

* 9. How can OLHSA improve our services? What other services could we offer?

* 10. Contact Information

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