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How
often do you rely on family or friends to transport you around or to keep you
company.
Not oftenVery often
1 2 3 4 5 N/A
Please rate accordingly
 
 






1.    
How often have you acted as a caregiver?



NoYes
1
2
3 4 5
Please rate accordingly
 
 






1.      How comfortable are you receiving assistance from a trained caregiver?



UncomfortableVery comfortable
1 2 3 4 5 N/A
Please rate accordingly
 
 




How
helpful would a caregiver that can bring you to medical, dental or
non-emergency appointments be?
Not helpfulVery helpful
1 2 3 4 5 N/A
Please rate accordingly
 
 






1.     
How much, if any, value do you see in a
service that will enable you to utilize a booking system to schedule time with a caregiver?



No valueSignificant value
1
2
3 4 5
Please rate accordingly
 
 






1.     
Would you use a service that connects you with a
caregiver that can satisfy all your transportation needs while also being there
for personalized requests? (Grocery shopping, playing card games, getting out
of the house … etc)



NoYes
1 2 3 4 5
Please rate accordingly
 
 




How
likely are you to purchase this type of service?
UnlikelyVery likely
1 2 3 4 5
Please rate accordingly
 
 
How many days in a month would you expect to use this type of service?
0>4 4>8 8>12 12>16 16>
Please rate accordingly
 
 
 
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