In order to get a better idea of what's working, what needs improvement, or what changes need to be made to our support groups, we are asking caregivers and family members to complete this survey. We are hoping to gain valuable information from the community in order to improve our groups.

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1. Please list the town you live in.

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2. Are you currently providing care or are a family member to someone with a dementia, chronic illness, or disability?

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3. Where do you go to get information about local events/resources?

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4. Do you currently attend a caregiver support group?
If yes, please answer questions 5-9.
If no, please answer questions 10-12

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5. If yes to number 4, please select the type below?

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6. If yes to number 4, what do you think works well for the group

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7. If yes to number 4, how did you initially hear about the group?

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8. If yes to number 4, what are some things that could be improved about the group? (time, day, location, etc.)

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9. If yes to number 4, what are some barriers you face when attending this group?

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10. If no to number 4, are you aware of the support groups available to caregivers and family members?

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11. If no to number 4, what prevents you from attending a support group?

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12. If no to number 4, what day/time/location would be ideal for a support group?

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13. Would you like more information regarding local support groups?

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