Knowledge Assessment for Seniors
Please complete this assessment to help us understand your knowledge in key areas. Your responses will remain confidential.
Full Name
*
First Name
Last Name
Email Address
example@example.com
Age Group
*
Please Select
60-65
66-70
71-75
76-80
81+
Which of the following is a healthy habit for seniors?
*
Exercising regularly
Skipping meals
Staying socially isolated
Other
Select all activities that can help keep your mind active:
*
Reading books
Solving puzzles
Watching TV all day
Learning a new skill
Other
Please briefly describe a healthy daily routine for seniors.
How confident do you feel about your knowledge on healthy aging?
*
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
Any additional comments or feedback?
Submit Assessment
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