Aging in Reston SurveyAging in Reston Survey (1)

Aging in Reston (AIR) is group of concerned citizens and organizations seeking to understand the needs and perceptions of Restonians and help create solutions toward making Reston a great place for people of all ages and abilities. Please take some time to complete this brief survey which will help with this effort and planning for an October 9 event at the Reston Community Center.

Questions? Call 703-966-6182 or neighborhoodplus@gmail.com

1

Are you a resident of Reston, VA?

Yes

No

If yes, how many years have you lived in Reston? If no, where do you live?

2

Do you feel that you feel that Reston is an "elder-friendly" community?

Yes

No

Please share any thoughts you have related to this

3

Which Village Center do you consider to be closest to your current home?

Lake Anne

Hunters Woods

Tall Oaks

South Lakes

North Point

Reston Town Center

4

Have you recently addressed the following issues?

Caring/planning for an elder friend/family in Reston

Caring/planning for an elder friend/family outside of Reston

Planning for my own retirement or eldercare needs

None of the above

Other, please specify

5

Would you be interested in learning more about the following resources in Reston?

Basic Needs - Meals, Shelter, Maintainance, Housekeeping, Etc.

Physical Health/Well-Being - Exercise, Health Screening, Available Medical Care, Etc.

Independence - Transportation, Safety and Mobility, Accessible Home Design, Etc.

Social and Civic Engagement - Connecting with Neighbors, Opportunities to help others, Access to Recreational and Social Activities

Other, please specify

6

Would you participate in a program to provide assistance to elders in Reston?

Access services for myself or a loved one

Volunteer to help others

Join a planning committee

Additional Comment

7

Please share any additional thoughts, questions or ideas related to Aging in Reston.

8

Optional - Please place me on the list to receive further information on Aging in Reston and the upcoming event at Reston Community Center on Oct. 9 from 1 - 5 p.m.

Optional - Please place me on the list to receive further information on Aging in Reston and the upcoming event at Reston Community Center on Oct. 9 from 1 - 5 p.m. Name
Company
Address 1
Address 2
City/Town
State/Province
Zip/Postal Code
Country
Email Address

9

Optional - Your gender

Male

Female

10

Optional - Your age