Purpose and Consent

The purpose of this survey is to identify Monrovia’s strengths, gaps, and priorities for action to raise awareness of dementia.  By having your insights, the Dementia Friendly Action Team can determine ways our Monrovia community can take action to build on the city’s assets and to fill gaps that will provide additional support.  The estimated time involved is 10-15 minutes.

As you answer the questions, consider dementia as a set of symptoms that includes impaired thinking and memory loss, as often associated with the cognitive decline of aging.  Common causes of dementia are Alzheimer’s Disease, Huntington’s Disease, and Parkinson’s Disease.

The Action Team championing this study will not be collecting any personally identifying information. All responses to this survey are anonymous and confidential. Your name or identity will not be linked in any way to the research data.  It is expected that responding to this survey will provide you with no more than minimal risk or discomfort which means that you should not experience any more troubling thoughts than during your normal daily life. While there are no direct benefits to participating, your response will help us to better understand dementia awareness in Monrovia. 

Your participation is entirely voluntary and you may refuse to participate or may withdraw from completing the survey at any time without penalty.  If questions arise, you may contact Jorge Vasquez at jvasquez@alzla.com or 323-930-6245.

I understand the purpose and my rights regarding the Dementia Friendly Monrovia Survey.  By continuing and completing the questions that follow, I am providing my consent to participate in this dementia awareness community survey.

These questions are designed to identify: Who responded, Your insights, and Your recommendations for next steps.