1. 2010 Public Hearing Survey

The West Central Florida Area Agency on Aging is your local Aging Resource Center. We strive to improve the lives of older adults, their families and caregivers. This survey will take approximately 5 minutes to complete and your answers will be used to help us provide better information and service to older adults living in our community. You may skip a question if it does not apply.

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* 1. What do you think are the biggest problems, issues or concerns of Older Adults and Caregivers living in your Community? (Check all that apply)

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* 2. Which of the following are the most important problems, issues or concerns for You and any Older Adults in your Family? (Check all that apply)

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* 3. What services or programs are you or older family members currently utilizing?

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* 4. Are you the primary caregiver for someone over the age of 60?

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* 5. Which services or programs for older adults would you like to see provided or increased?

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* 6. What suggestions do you have for solving any of the above problems or concerns?

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* 7. Many people participate in "social networking" activities via the Internet. If you do, please indicate which of the following social networking sites or services you use regularly or have used in the past year:

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* 8. Please list the top 4 or 5 websites you visit for information on issues affecting older adults. (If you do not know the actual web address, please indicate the name of the company or organization that hosts the web site)

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* 9. Would you be interested in getting additional information about programs and services, caregiving, health and wellness, etc. via the Internet? (For example, watching instructional videos on topics of interest to you, chatting with experts about various issues, exchanging information with other people who share your concerns, etc.)

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* 10. Would you be interested in learning more about volunteer opportunities with the West Central Florida Area Agency on Aging?

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* 11. What suggestions do you have for us as we try to improve the ways we assist and provide information to older adults and their caregivers?

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* 12. Please provide your name and email address so we may contact you about those items that interest you: (We will not share you email address with any other organization)

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* 13. Which county do you live in?

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* 14. What is your age? (Optional)

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* 15. Are you currently employed in a business or profession where you provide goods or services to older adults?

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