Senior Survey

 

Please complete this survey and update your contact information, so I am better able to understand your concerns and keep you informed about community events and state-related news. If you’d like to fill out a hard copy of the survey, please call my office at 717-244-9232 and we will mail one to you.
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Are you a Veteran? *

Are you a Widow/Widower of a Veteran *
Communication and Information

Can you easily access information that you need about your community? *

Social and Civic Engagement

Are you willing to mentor and teach others? *

Are you willing to volunteer in your community? *

Housing

Do you use a cane, walker or wheelchair? *

Have you been able to do general upkeep around your house or apartment? *

Have you ever used the Whole Home Repair program? *

Would you benefit from home care or home health care? *

Senior Center Participation

Have you utilized any of the following senior center services during the last 6 months? Check all that apply. *

Concerns
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