Sector Questionnaires

Where applicable, please complete one or more of the following sector questionnaires. Our goal is to complete 100 questionnaires per sector.

• Care Partners: (questionnaires completed 81)
  • Care Partner Questionnaire (Online Version) or (Paper Version)
    • For adult day services, respite care, support groups or counseling
• Community Services: (questionnaires completed 28)
  • Community Services Questionnaire (Online Version) or (Paper Version)
    
    • For wellness programs (e.g., fitness centers, YMCA/YWCA), meaningful engagement programs/activities (e.g., creative arts, music, group programs), services that support independence at home (e.g., chore, home safety, meal delivery), senior centers, community health workers, adult day care
• Government: (questionnaires completed 41)
  • Local Government Questionnaire (Online Version) or (Paper Version)
    
    • For city / Town council members, inspectors, planners; emergency responders, human services staff, police/sheriff, and public health staff
• Healthcare: (questionnaires completed 57)
  • Clinic Questionnaire (Online Version) or (Paper Version)
    
    • For physicians, physician assistants, nurse practitioners, nurses, nurse aides, medical assistants, social workers, care coordinators
  • Hospital Questionnaire (Online Version) or (Paper Version)
    • For physicians, physician assistants, nurse practitioners, nurses, nurse aides, medical assistants, social workers, care coordinators
  • Home Care Questionnaire (Online Version) or (Paper Version)
    • For home care agencies
  • Residential Setting Questionnaire (Online Version) or (Paper Version)
    • For independent living communities and assisted living residences
  • Skilled Nursing Home Questionnaire (Online Version) or (Paper Version)
    • For skilled nursing homes

If you have any questions, please contact Isaac via email (santai@ccf.org) or phone (702-685-7072). Thank you!