Senior Living Activities Survey Form
Help us improve our community activities by sharing your preferences and feedback.
Please select your role:
*
Senior Resident
Caregiver/Family Member
Which types of activities are you most interested in? (Select all that apply)
*
Arts & Crafts
Music & Entertainment
Physical Exercise
Games & Puzzles
Social Events
Educational Talks
Other
How often do you or your loved one participate in community activities?
*
Daily
A few times a week
Once a week
Occasionally
Rarely / Never
How satisfied are you with the current selection of activities?
*
1
2
3
4
5
Please rate the importance of the following activity types:
*
Rows
Not Important
Somewhat Important
Very Important
Physical Exercise
1
2
3
Arts & Crafts
4
5
6
Music & Entertainment
7
8
9
Games & Puzzles
10
11
12
Educational Talks
13
14
15
What are the main reasons you or your loved one might not participate in activities? (Select all that apply)
Lack of interest
Scheduling conflicts
Physical limitations
Transportation issues
Unaware of activities
Other
Which times of day are best for participating in activities?
*
Morning
Afternoon
Evening
Flexible/No preference
Are you interested in trying any new types of activities?
Yes
No
Not sure
If yes, what new activities would you like to see offered?
Please share any additional comments or suggestions:
Submit Feedback
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