ASHA CARE HOMES
ASHA SENIOR LIVING1st Floor, Koluthara Towers, near Marappalam, Pattom, Trivandrum, Kerala, India1800-102-8313/ +91-9633959632
SURVEY TO UNDERSTAND THE AWARENESS AND ACCEPTANCE OF SENIOR LIVING FACILITIES IN KERALA
Please Note : Kindly Share your contacts only if you are interested in our services. Otherwise kindly mention only your name and indicate other details as ' NIL'
Age & Gender
Currently Residing at
Name of Residential Association
1. Who all live in your home (other than yourself)?
My son and/ or daughter
Extended family of son and/ or daughter
Other Senior citizen (s)
2. Where do your children live?
Outside the country
Different city (from where I live)
Same city but different locality
3. Are you aware about any Senior living facilities?
3. 1 If Yes for Question 3, Please share the details of the Senior living facility you are aware of
4. Would you like to consider moving to a Senior Citizens community sometime?
5. For whom would you like to opt a Senior Living facility?
Spouse & Self
Parent or In- Law
6. What type of living will you or your loved one prefer?
CCRC(Continuing Care Retirement Community : Resort style Amenities and care)
7. We are planning to open up a new facility in Trivandrum. According to you, what all facilities are required for the residents in the property?
8. We offer many amenities such as fitness programs, extensive opportunities for socialization and alternative wellness modalities such as swimming pool that are unique to our community. Please select your choice of facilities.
2. Swimming Pool
3. Club facility
5. Primary Health Care
6. Home Nursing Services
9. How much do you think would be an appropriate pricing per month(in Rs) based on the facilities you have chosen in question 8?
25000 to 30,000
30,000 to 45,000
45,000 to 60,000
10. Are you aware about some senior citizen who would be requiring / waiting to move in to a Senior Living Facility? (please share their contact details )
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service