This free survey is powered by
0%
Exit Survey
 
 
Hello: Thank you for choosing Seniority1 to be your Virtual Geriatric Consultant. In the following SmartNeeds Assessment you will be asked . In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire. Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions. Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below. Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
 
 
 
* Who will be completing this assessment for the senior who needs help?
 
I am the senior who needs help
 
I am the spouse
 
I am the child of the senior
 
I am the grandchild of the senior
 
I am the grand child of the senior
 
I am the sibling of the senior who needs help
 
Other
 
 
 
 
* what do you like better dogs or cats or horses?
 
Dogs
 
Cats
 
Horses
 
None
 
Other
 
 
 
 
* What do you like about dogs?
   
 
 
 
* What do you like about cats?
   
 
 
 
* What do you like about horses?
   
 
 
 
Do you have a dog?
 
yes
 
No
 
 
 
How often do you conduct surveys
 
 
 
 
Name