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* 1. In what age group do you belong?

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* 2. What is your gender?

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* 3. Overall how would you rate your physical activity?

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* 4. How would you rate your social activity?

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* 5. How would your rate your overall health?

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* 6. In Gander,  how are adults 55+ generally treated?

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* 7. Do you feel connected and respected in your Community?

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* 8. How would you rate the recognition given to seniors (events, awards, etc.) in the Community?

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* 9. Do you feel as though the seniors regularly have the opportunity to be consulted on local issues in Gander?

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* 10. How would you rate the accessibility of rest areas in Gander's parks and trails?

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* 11. How would you rate the streets/sidewalks for use by persons with limited or compromised mobility?

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* 12. How would you rate the main snow removal services around the Community? (streets and sidewalks)

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* 13. How would you rate maintenance of parking lots for public buildings? (i.e., cleared of snow and ice, pots holes)

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* 14. How would you rate the accessibility to public buildings (churches, halls, businesses) for people with limited or compromised mobility?

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* 15. How would you rate the accessibility of aisles and shelves in supermarkets/convenience stores?

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* 16. How would you rate accessibility of public washrooms in our community?

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* 17. How would you rate the availability of subsidized housing for low-income seniors?

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* 18. How would you rate the availability of services such as; snow removal from walks and driveways and lawn care to support seniors in the community?

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* 19. Do you believe that the wait times to get into seniors housing are reasonable? (This does not refer to long term care facilities)

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* 20. How would you rate the availability of volunteer opportunities available in the community for older adults?

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* 21. Do you feel that membership and participation in community groups and associations is encouraged for older adults in Gander?

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* 22. Do you feel that community activities and events attract all ages and cater to age related needs and preferences? (location, time, type of activity, etc)

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* 23. Do you think that it's easy to find out information about, and participate in social activities and community events?

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* 24. Are forms, brochures, newsletters and public notices in large print?

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* 25. Is the automated telephone answering services in various buildings easy to use?  (ie: drug stores, banks, Town Hall)

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* 26. How would you rate the availability of persons or groups in town who assist seniors with completing forms such as income tax returns?

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* 27. How would you rate the availability of groups/individuals/services who regularly visit to supply information to people who are unable to leave their homes?

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* 28. How would you rate the public access to computers and internet, at no or minimal cost, in public spaces such as local buildings and the Library?

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* 29. Are you aware of relief or respite services available for family caregivers in your community?  (Respite care is the provision of short-term, temporary relief to those who are caring for family members)

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* 30. If yes, how would you rate these services?

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* 31. Is clear and accessible information provided about health and social services to seniors?

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* 32. Have you ever had any problems affording the health services you needed?

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* 33. Have you ever needed to use homecare services, either for yourself or your partner?

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* 34. If yes, how would you rate these services?

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* 35. How would you rate the availability to have groceries and medicines delivered at an affordable cost?

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* 36. How would you rate the availability of transportation to medical appointments and its affordability?

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* 37. How would you rate ambulance services?

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* 38. How safe do you feel in your own home?

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* 39. How safe do you feel in your community?

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* 40. From the options below please select the 3 most important aspects needed to ensure social participation, respect and inclusion.

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* 41. From the options below, please select the 3 most important aspects to ensure activities and events in your community are age friendly.

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* 42. Using the list below, please indicate what sources you use to find out about the services and activities that are going on in Gander?

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