Sunshine Centres for Seniors Program Survey

This survey is voluntary and confidential. It is a chance for you to give feedback on Sunshine Centres for Seniors’ programs. If you do not want to answer a question, you can skip it or choose “prefer not to answer”. You do not have to disclose (or share) anything you do not want to. There are 23 questions.

What you share will never be linked to you. We collect your initials only to make sure that each person is only responding to the survey once. Surveys will be analysed together to inform Sunshine Centres for Seniors' programming. 

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Which program location are you providing feedback on? Please check only one.  *
Please add your initials (the first letter of your first name and the first letter of your last name, e.g., "Jane Smith" would be "J.S."). This will be used ONLY to make sure each person is only responding to this survey once. It will never be linked to your response.  *

1. How long have you been coming to our program? Choose one response:

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2. Why do you come to the program? Check all that apply: 

3. Do you live in the neighbourhood of the program location, or do you travel from another neighbourhood? 

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4.  On a scale of 1-5, how much has this program had a positive impact on your social connections?  
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5. On a scale of 1-5, how much has this program increased your sense of self-worth (how you feel about yourself)? 

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6. On a scale of 1-5, how much has this program increased your sense of independence? 

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7. On a scale of 1-5, how much has this program increased your sense of belonging?

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8. On a scale of 1-5, how much has the program had a positive impact on your overall well being? 
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9. On a scale of 1-5, how much has the program had a positive impact on your physical health?

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10.  On a scale of 1-5, how friendly and supportive is the staff team? 
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11. What do you enjoy most about the program? 

12. Overall, on a scale of 1-5 how satisfied are you with the program? 

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13. How old are you? 
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14. We know that language barriers can impact people’s experiences when accessing health services and other programs. In order to understand language profiles of our clients/patients, we are going to ask you about language. What language do you prefer speaking? Please select one only.
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15. What are your English speaking skills?  

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16. Do you identify as any of the following? Check all that apply:  

17. If you are a newcomer to Canada, what country are you from? 

18. We are asking all our survey respondents about their gender and sexual identities. This will help us monitor how services are impacting different communities. With this information we are able to respond to specific community needs and better plan for your social supports, public health, and other services. Gender identity is the gender that people identify with or how they perceive themselves, which may be different from their sex assigned at birth. Which of these best describes your gender? Please select only one.
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19. Sexual orientation describes a person's emotional, physical, romantic and/or sexual attraction to other people. What best describes your sexual orientation? Please select one only.
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20. We know that economic situations matter a lot in the types of services and programs that are needed. What was your total household income before taxes last year? Your best estimate is fine. Please select one only.

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22. What is your postal code?

23. Do you have other comments about the program that you would like to share? 

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