We are looking for your views on our Draft Older Persons Strategy.  Please give us as much information as you can and add any additional comments.  Thank you.

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* 1. Name

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* 2. Address

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* 3. Phone (Landlne) 

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* 4. Phone (Mobile)

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* 5. Email Address

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* 6. What do you think Thenue's priorities should be for meeting the needs of older tenants?  Please tick your top 3

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* 7. Do you think we should hold locally based Older Peoples events on an annual basis?

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* 8. Would you attend local events for Older People?

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* 9. Do you live in a Retirement Housing Service block?

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* 10. If no, would you like more information about our Retirement Housing Service?

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* 11. Would you be interested in joining a Focus Group for older people (eg, to discuss issues of common concern, ideas for services or activities, etc)?

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* 12. Would you like help to move to a smaller house if you have more bedrooms than you need?

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* 13. Do you need any aids or adaptations to help you manage better at home?

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* 14. Do you have any other comments about how we can meet the needs of older people in our communities?

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* 15. Do you have:

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* 16. In general, how do you prefer that we communicate with you?

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* 17. Is English your first language?

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* 18. Do you consider yourself to have a disability?

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* 19. What is your ethnic origin?  (Please click on the arrows to make your choice) 

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* 20. If you have a mixed, multiple or other ethnic background, please specify below

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* 21. This is the end of our survey.  Thank you for completing it.

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