Town of Amherst N.H. Senior Citizen Survey

The purpose of this survey is to enable the town to learn more about the concerns and needs of our Senior Citizen population in order to best improve their "quality of life".
Information provided to this survey will be confidential and only used for the Town's understanding and analysis.

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* 1. Would you like to keep your identity anonymous?

Yes

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* 2. Name

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* 3. Address

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* 4. Email

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* 5. Phone Number

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* 6. Cell Phone Number

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* 7. Approximate age

60-69

70-79

80-89

90+

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* 8. How long have you lived in Amherst?

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* 9. Please check the services or programs with which you are familiar.

Recreation Department programs for seniors

Walking during the winter in the Hampshire Dome

Library programs for seniors

Servicelink (The Aging and Disability Resource Center)

The Little Blue Bus

Other (please specify)

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* 10. Are you satisfied with the services currently provided by the Town of Amherst for Senior Citizens?

Yes

Explain

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* 11. What programs, opportunities or services could the Town of Amherst provide that you feel would improve your quality of life?

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* 12. What are your concerns or frustrations with the programs or services that the Town of Amherst provides for its Senior Citizens?

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* 13. Would you benefit from more social interaction within the Amherst Community?

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* 14. Speaking as a Senior in our community, what suggestions have you for making our community more Senior Citizen-friendly?

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* 15. How do you currently get information on the programs and services offered by Amherst?

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* 16. Would you be willing to have a follow up interview to provide us with a more detailed response for our report?

Yes

If "Yes", would weekdays or weekends be more convenient for you?

Town of Amherst N.H. Senior Citizen Survey