Foundation on Aging Assessment & Needs Survey
Welcome to our Foundation on Aging Assessment & Needs Survey.
Welcome to the Foundation on Aging Assessment & Needs Survey. Please take a minute to complete all questions as your opinion matters to us. We utilize your feedback to improve our programs and services.
Thank you.
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1.
LOCATION OF RESIDENCE
This survey is intended to gather information from residents of Larimer County. Where do you live?
Berthoud
Estes Park
Ft. Collins
LaPorte
Loveland
Red Feather Lakes
Wellington
2.
AGE
Please check the category that includes your age.
Under 60 years
60 - 65 years
66 - 70 years
71 - 75 years
76 - 80 years
81 - 85 years
86 -90 years
Over 90 years
3.
SUPPORT SERVICES
Please check those items below which you consider to have a HIGH LEVEL OF UNMET NEEDS in Larimer County.
Adult Day Care
Benefits Counseling
Case Management
Emergency Preparedness Plans
Family Caregiver Assistance
Financial Counseling
Friendly Visitor Programs
Home-delivered Meals
Home Care Services
Housing & Home Improvement
Information & Assistance
Job Training & Placement for Older Workers
Legal Assistance
Mealsite Accessibility
Personal & Family Counseling
Respite Services
Transportation
Utilities Assistance
Volunteer Programs
If other, please specify
4.
HEALTH CARE
Please check up to 3 items below that you believe are of greatest concern in Larimer County.
Assisted Living
Dental Health
Home Health Care
Hospice Care
Medicare Acceptance by Health Professionals
Medicaid Acceptance by Health Professionals
Medication Management
Mental Health Services
Prescription Drug Costs
Nutrition
Preventative Care
Primary Care
Skilled Nursing
Rehabilitation
Understanding Health Insurance
Vision & Hearing Care
Wellness & Fitness
If other, please specify
5.
ECONOMIC SECURITY
Please check up to 3 items below that you believe are of greatest concern in Larimer County.
Affordability of Home-based Services
Affordability of Long-term Care Facilities
Cost of Utilities
Financial Planning
Food Costs
Fraud & Exploitation
Health Care Costs
Job Opportunities
Job Training
Public Benefits Counseling
Tax Credits & Exemptions
If other, please specify
6.
TRANSPORTATION SERVICES/EASE OF MOBILITY
Please check up to 3 items below that you believe are of greatest concern in Larimer County.
Public transportation
Cost of transportation services
Door-to-door options that support disabilities
Sidewalks and street crossing made safe and accessible
Sidewalks that link housing and essential services
If other, please specify
7.
HOUSING
Please check up to 3 items below that you believe are of greatest concern in Larimer County.
Affordability of services that enable living at home
Home maintenance & repair assistance
Housing codes that consider the needs of an aging community
Property taxes that take fixed incomes into account
Subsized housing facilities
If other, please specify