Long-term Care Choices Navigator Survey

1. Is this the first time you used the Navigator? *

2. How did you first hear about this site? *

Other *

3. In general, what is the PRIMARY reason you came to the site? *

Other *

4. Did you find what you needed? *

If you did not find any or all of what you needed, please tell us the difficulties you had. *

6. Did the information help you make a decision? *

7. What is the likelihood you will refer this website to a friend or colleague? *

Additional Questions: Please select No Answer if not applicable.

8. What best describes you? *

9. County *

10. Age *

11. Gender *

12. Race/Ethnicity *

American Indian or Alaskan Native

Black, African American

Filipino

Hispanic, Latino or Spanish Origin

Korean

Other Asian

Samoan

Vietnamese

Asian Indian

Chinese

Guamanian or Chamorro

Japanese

Native Hawaiian

Other Pacific Islander

Some Other Race/Ethnicity

White, Non-Hispanic

No Answer

Give us your feedback on on the Long-Term Care Choices Navigator!