2019 Region 2 Area Agency on Aging Community Needs Assessment
Thank you for participating in the Region 2 Area Agency on Aging community needs assessment. Your feedback will directly effect the organization and development of services offered to older adults and adults with disabilities in Hillsdale, Jackson and Lenawee Counties. The survey will collect information on the following: demographics, health, housing, finances, transportation, unmet needs and service usage. The survey is completely anonymous and none of your personal information will be shared.

Your participation in this survey is not required but is very much appreciated. The survey should take you approximately 15 minutes to complete.

Personal Demographics
Responses in this section help us know who responded to this survey
What county do you live in?
Primary language other than English:
Your answer
Indicate your age group
Indicate your total household income in 2018
Which of the following best describes your relationship status?
Including yourself, how many people live in your household?
Your answer
Indicate where you live
If you have recently moved or are considering moving in the near future, what are the reasons? (Check all that apply)
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service