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Hanover Township Senior Services and Catholic Charities Northwest Senior Services are committed to supporting the caregivers in our community.

Our Caregiver Support Group meets on the 4th Wednesday of every month from 10:30 a.m. to 12:00 p.m. at Hanover Township Senior Center @ 240 S. IL Rt. 59, Bartlett, IL 60103.

Taking a few moments to complete this survey will be extremely helpful in tailoring our support group and other caregiver services to YOU!

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1. What is your age?

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2. Are you male or female?

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3. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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4. Who do you provide care for?

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5. What condition does the person you care for have (check all that apply)?

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6. What would motivate you to attend a caregiver support group (check all that apply)?

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7. What might be preventing you from attending the Caregiver Support Group at Hanover Township Senior Center (check all that apply)?

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8. Would you like to see informational/educational opportunities offered in addition to the regularly scheduled monthly caregiver support group meetings?

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9. What topics would be of most interest to you as a caregiver (check all that apply)?

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10. What is your preferred format for an educational presentation (check all that apply)?

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11. Any further comments or suggestions:

Thank you for taking the time to complete this survey!
To be added/removed from our caregiver mailing/call list, please contact Amy Seul @ 630-483-5682

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