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* 1. How long have you lived in Milton?

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* 2. To the best of your knowledge, how would you rate Milton as a place for the following people to live?

  Excellent  Very good  Good  Fair Poor 
Elderly people
Young families 
Young, single households
Middle aged families
Racial or cultural minority 

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* 3. Some people find that they need or want to move out of Milton. To the best of your knowledge, which of the following would be a factor in your decision to move?

  Major factor  Minor factor Not a factor Not sure
Wanting a larger size home 
Wanting a smaller size home 
Lack of affordable housing
Your personal safety or security concerns
Wanting to move to an area that has better healthcare facilities 
Needing more access to public transportation
Wanting to live in a different climate
Wanting to live in an area with better opportunities for social interaction 

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* 4. Which of the following homes best describes where you currently live?

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* 5. How important is it for you to be able to live independently as you age?

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* 6. To the best of your knowledge, how would you rate Milton's town center as having the following?

  Excellent  Very good Good  Fair  Poor 
Sidewalks that are safe for pedestrians and accessible for assistive mobility devices
Well-lit, accessible, safe streets and intersections for all users 
Separate pathways for bicyclists and pedestrians
Well-maintained sidewalks and streets

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* 7. To the best of your knowledge, how would you rate Milton as having the following?

  Excellent  Very good  Good Fair  Poor
Accessible and convenient public transportation 
Affordable public transportation
Timely public transportation
Safe public transportation stops or areas that are accessible to people of varying physical abilities

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* 8. Thinking about health and wellness services, how would you rate Milton as having the following?

  Excellent  Very good  Good  Fair  Poor 
Affordable fitness activities 
Affordable home care services including personal care and housekeeping 
Affordable mental health services 
Outdoor activities 

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* 9. Do you agree with the following

  Yes  No
I feel socially accepted when in public
I feel included in my community
I feel my interests are represented in my local government
I would feel comfortable serving on a town committee
I feel that being a diverse community is a strength
I feel that promoting inclusion is an important community goal

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* 10. To the best of your knowledge, how would you rate Milton as having the following?

  Excellent Very good  Good Fair  Poor 
A range of volunteer activities to chose from
Volunteer training opportunities 
Opportunities for all people to participate in town committees
Easy to find information on available local volunteer opportunities 

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* 11. To the best of your knowledge, how you would rate Milton as having the following?

  Excellent Very good Good  Fair  Poor 
A range of flexible job opportunities in terms of scheduling
Inclusive job training opportunities
Jobs that are adapted to meet the needs of people with disabilities
A fair culture that ensures all identities have equal opportunities to work

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* 12. Would you turn to the following resources if you or someone you know needed information about services such as caregiving, home repair, social activities, child care, or car services?

  Yes  No 
Local nonprofit 
Family or friends
Faith-based organizations
Internet
Phone book
Town Recreation Department
Library 
Front Porch Forum

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* 13. To the best of your knowledge, how would you rate access to community information in Milton?

  Excellent Very good Good Fair Poor 
Available in one central source
Clearly displayed and printed
Free access to the internet in public spaces
Delivered to those who may have difficulty leaving their home
Available in different languages

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* 14. What is your gender?

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* 15. How old are you?

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* 16. What is your current marital status?

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* 17. Besides yourself, do any of the following people live in your household?

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* 18. Does any part of your identity (age, physical ability, racial identity, religion) keep you or your spouse or partner from participating fully in work, school, or other activities?

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* 19. Are you currently an unpaid caregiver to an adult loved one?

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* 20. Are you currently planning to have a child?

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* 21. What is the highest level of education you have completed?

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* 22. What native language do you speak at home?

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* 23. What is your race/ethnicity (check all that apply)?

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* 24. What is your annual household income this year?

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