Have you fallen within the past 6 months?

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* 1. Have you fallen within the past 6 months?

Have you fallen within the past year?

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* 2. Have you fallen within the past year?

Are you afraid of falling?

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* 3. Are you afraid of falling?

What are some precautionary steps that you take to prevent falling?

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* 4. What are some precautionary steps that you take to prevent falling?

What, as a DEPARTMENT, could we do to ensure safety from falling for our elders?

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* 5. What, as a DEPARTMENT, could we do to ensure safety from falling for our elders?

What do you think causes the most falls among elders?

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* 6. What do you think causes the most falls among elders?

If you answered other- what other reasons do you feel cause the most falls among elders?

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* 7. If you answered other- what other reasons do you feel cause the most falls among elders?

Name & Size of YakTrax (For YakTrax Tracking purposes ONLY)

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* 8. Name & Size of YakTrax (For YakTrax Tracking purposes ONLY)

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