Township of West Orange
Aging in Place 2017 Needs Assessment: Resident Survey
Who should respond to this survey? Adult residents, age 55 years or older, of West Orange.

Why is this assessment being done? The Township of West Orange, in partnership with Center for Research and Evaluation on Education and Human Services (CREEHS), is conducting a needs assessment to better understand the characteristics, assets, needs, and future plans of community residents aged 55 years and older. This assessment is funded by the Partners for Health Foundation.

What will happen while you are in the assessment? You have been invited to participate in this assessment because you are currently a resident, age 55 years or older, of West Orange. If you decide to participate, you will be asked to complete a brief survey about your perceptions of the resources and needs of your community. The survey includes questions about community, communication, health, housing, transportation, quality of life, and some background information about you.

Time: The survey will take about 60 minutes to complete.

Risks: There are no major risks to participating in this survey. While there is no guarantee on the security of data sent on the Internet, confidentiality will be kept to the degree permitted by the technology used.

Benefits: You may benefit from this assessment because your responses may help to improve West Orange. In turn, this may enhance the services and resources available to adults in your community.

Who will know that you are in this assessment? No one will know that you participated in this survey. We are not collecting IP addresses. You will not be asked to identify yourself by name or organization.

Do you have to be in the assessment? Participation in this survey is voluntary. You are free to stop at any time. You may skip questions you do not want to answer. Your decision whether or not to participate will not affect your relationship with the Township of West Orange or Montclair State University.

Do you have any questions about this assessment? You may contact me if you have questions at 973-655-3543 or bungere@montclair.edu.

Thank you for your time.

Erin Bunger, MPH, Senior Research Associate
Center for Research and Evaluation on Education and Human Services (CREEHS)

* 1. By proceeding to the survey, I confirm that I have read this form and will participate in the project described. Its general purposes, the particulars of involvement, and possible risks and inconveniences have been explained to my satisfaction. I understand that I can discontinue participation at any time. My consent also indicates that I am 18 years of age.