AmeriCorps Seniors Perceived Health Survey

Thank you for participating in our survey.  This survey is based on one developed by the Corporation for National and Community Service (CNCS) to evaluate the types of people who join a Senior Corps program.  Because Senior Corps is comprised of Foster Grandparent, Senior Companion and RSVP Programs, some of the questions may seem to be irrelevant.  However, they are important to establish a profile of our volunteer population.  
1.I am a...
2.If you are already a RSVP Volunteer, how long have you been serving? 
3.Have you spent any time in the last 12 months doing volunteer work for religious, educational, health-related or other charitable organizations not associated with or in addition to your RSVP assignment(s)?
4.Which group best reflects your age today?
5.Gender
6.Race:
7.Ethnicity:
8.Education:
9.Estimated Household Income
10.Marital Status:
11.Do you live alone or with someone?
12.Did you serve in a branch of the military?
13.How would you rate your health?
Excellent Health
Very Good Health
Good Health
Fair Health
Poor Health
Health Status Self Assessment
14.Because of a health problem do you have any difficulty with walking one block?
Yes
No
Can't Do
Don't Do
I don't know
Mobility
15.Please think about your life-as-a-whole. How satisfied are you with it? Are you satisfied or not satisfied?
Completely Not Satisfied
Not Very Satisfied
Somewhat Satisfied
Very Satisfied
Completely Satisfied
General Life Satisfaction
16.Please think about your volunteering experiences with RSVP.  How satisfied are you with your volunteer assignments?  Are you satisfied or not satisfied?
Completely Not Satisfied
Not Very Satisfied
Somewhat Satisfied
Very Satisfied
Completely Satisfied
Have not volunteered with RSVP yet
RSVP Volunteering Satisfaction
17.Do you feel that your volunteering experiences have anything to do how satisfied you feel about your life-as-a-whole?
18.Do you feel that there are people that you are close to?
Never
Hardly ever
Some of the time
Often
Always
Connectivity
19.Do you feel that you can do the things you want to?
Strongly Disagree
Somewhat Disagree
Slightly Disagree
Slightly Agree
Somewhat Agree
Strongly Agree
Self-Efficacy
20.Do you feel that you lack companionship?
Never
Hardly Ever
Some of the time
Often
Always
Companionship
21.What are some of the reasons that motivate you to want to volunteer? 
Not at all
Rarely
Some of the time
Most of the time
All of the time
Help Another Person/Children
Earn Extra Money
Keep Busy/Fill My Time
Learn Something New
Make Me Feel Better
Make New Friends
Get More Experience
Learn a New Skill or Hobby
Have a Sense of Accomplishment
Improve My Community
Learn About Myself
22.How did you learn about RSVP?
Current Progress,
0 of 22 answered