Senior Living Consumer Survey Form
Please share your feedback to help us improve our senior living community. All responses are confidential and anonymous.
How long have you (or your loved one) been part of our community?
*
Please Select
Less than 6 months
6-12 months
1-2 years
More than 2 years
What is your relationship to the resident?
*
Resident
Family member
Friend
Other
Overall, how satisfied are you with the senior living community?
*
1
2
3
4
5
Which aspects of our community do you value most? (Select all that apply)
Cleanliness
Staff friendliness
Quality of food
Safety and security
Activities and events
Amenities
Other
How would you rate the friendliness and helpfulness of our staff?
*
Not friendly
1
2
3
4
Extremely friendly
5
1 is Not friendly, 5 is Extremely friendly
How satisfied are you with the activities and events offered?
Not satisfied
1
2
3
4
Very satisfied
5
1 is Not satisfied, 5 is Very satisfied
How likely are you to recommend our community to others?
*
Not likely
1
2
3
4
Extremely likely
5
1 is Not likely, 5 is Extremely likely
What would you most like to see improved?
Please share any additional comments or suggestions.
Submit Survey
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