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Aging Services Survey: How Are We Doing?

Steps

  1. 1. Step One
  2. 2. Survey Questions
  3. 3. Contact Information
  • Step One

    1. You will be assisting the Richmond County Aging Services by providing useful information concerning our community and how service to our older adults and their caregivers can be enhanced. When completing this form, it is not necessary that you provide your name or address as anonymous submissions will be accepted. When completed, please press the Submit button, or if you prefer, print it out and mail to the address provided at the end of the survey.

    2. Please complete this survey if you are 55 years or older. For each question, please circle your best answer.

    3. What is your age group?*

    4. If you are not at least 55 or older, please do not complete this survey.

    5. Do you reside in Richmond County?*

    6. Where do you reside?*

    7. What is your gender?*

    8. Are you?*