Catholic Assisted Living Preference Survey - Parish Copy Question Title * 1. Please answer the first question to begin the survey: How old are you? Under 65 65-74 75-84 85+ Question Title * 2. What is your gender? Male Female Question Title * 3. What is your Religious Affiliation? Roman Catholic Other Christian Other Religion No religious affiliation Question Title * 4. How often do you attend Mass or religious services? Weekly Monthly Occasionally Rarely Never Question Title * 5. Are you currently a member of a Catholic parish? Yes No Question Title * 6. Who is completing this questionnaire? I am a senior who may consider living in an assisted living community I am an adult child or family member answering on behalf of a senior Other Question Title * 7. If you are a family member: How important is faith to your loved one in choosing an assisted living facility? Very important Somewhat important Neutral Not so important Unsure Question Title * 8. How important is it for your assisted living facility to reflect your Catholic faith? Very important Somewhat important Neutral Not important Question Title * 9. Which of the following Catholic services would you value in a facility? (Check all that apply) On-Site Mass Access to a chapel Visits from clergy Rosary groups Catholic holidays and feast days observed Catholic-based counseling or spiritual care Question Title * 10. Would you feel more comfortable in a community where staff and residents share your faith? Yes No Not sure Question Title * 11. Do you believe a Catholic facility would better support your emotional and spiritual well-being? Yes No Neutral Question Title * 12. How far would you be willing to travel or relocate for a Catholic-based senior housing community? Within 5 miles 5-15 miles 15-30 miles More than 30 miles Question Title * 13. How far would you be willing to travel or relocate for a NON-Catholic based senior housing community? Within 5 miles 5-15 miles 15-30 miles More than 30 miles Question Title * 14. Have you ever lived in or visited a secular assisted living facility? Yes No Question Title * 15. If yes, what did you feel was missing in terms of faith or spiritual support? Question Title * 16. Would you be willing to pay more for a Catholic-based assisted living facility that offers faith-centered services? Yes No Depends on cost Question Title * 17. If you have any other questions, comments or suggestions please write them below. Done