Frequency Survey - Caregivers

Question Title

* 1. Which age range describes you?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

Question Title

* 2. Which of the following best describes you?

I am a senior who lives at home and receives help from an INDEPENDENT CAREGIVER.

I am a senior who lives at home and receives help from a CAREGIVING AGENCY.

I have a parent who lives at home and receives help from an INDEPENDENT CAREGIVER.

I have a parent who lives at home and receives help from a CAREGIVING AGENCY.

None of the above.

Question Title

* 3. Answer the following frequency questions regarding the caregiver that you use yourself or that you employ for a parent, if applicable.

	Always	Usually	Sometimes	Rarely	Never	Not Applicable
I trust my caregiver.	I trust my caregiver. Always	I trust my caregiver. Usually	I trust my caregiver. Sometimes	I trust my caregiver. Rarely	I trust my caregiver. Never	I trust my caregiver. Not Applicable
I overpay for my caregiver.	I overpay for my caregiver. Always	I overpay for my caregiver. Usually	I overpay for my caregiver. Sometimes	I overpay for my caregiver. Rarely	I overpay for my caregiver. Never	I overpay for my caregiver. Not Applicable
My caregiver is late.	My caregiver is late. Always	My caregiver is late. Usually	My caregiver is late. Sometimes	My caregiver is late. Rarely	My caregiver is late. Never	My caregiver is late. Not Applicable
My caregiver cancels last minute.	My caregiver cancels last minute. Always	My caregiver cancels last minute. Usually	My caregiver cancels last minute. Sometimes	My caregiver cancels last minute. Rarely	My caregiver cancels last minute. Never	My caregiver cancels last minute. Not Applicable
I need to book a caregiver last minute.	I need to book a caregiver last minute. Always	I need to book a caregiver last minute. Usually	I need to book a caregiver last minute. Sometimes	I need to book a caregiver last minute. Rarely	I need to book a caregiver last minute. Never	I need to book a caregiver last minute. Not Applicable
I want to change caregivers.	I want to change caregivers. Always	I want to change caregivers. Usually	I want to change caregivers. Sometimes	I want to change caregivers. Rarely	I want to change caregivers. Never	I want to change caregivers. Not Applicable
My family receives updates from my caregiver.	My family receives updates from my caregiver. Always	My family receives updates from my caregiver. Usually	My family receives updates from my caregiver. Sometimes	My family receives updates from my caregiver. Rarely	My family receives updates from my caregiver. Never	My family receives updates from my caregiver. Not Applicable

Question Title

* 4. What is your email address? Note: Your email address will only be used to enter you into the drawing to win prizes. You will be contacted via email if you win. Your email address will not be shared and all reports resulting from this survey will remain anonymous.