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If you answered yes to the previous question then continue. Was the person a family member?
 
Yes
 
No
 
 
 
If you answered yes to the previous question, then skip this question, if you answered no then continue. Was the person you were caring for a friend or a neighbor?
 
Friend
 
Neighbor
 
 
 
Are you currently a paid caregiver?
 
Yes
 
No
 
 
 
Are you a state certified caregiver?
 
Yes
 
No
 
I prefer not to say
 
 
 
Where do you provide that care for the person at (Check all that apply)
 
In their home
 
In your home
 
A nursing home
 
An assisted living facility
 
Multi-generational center
 
Other
 
 
 
Would you ever consider being part of a larger research study to raise the awareness of a cause that you believed in?
 
Yes
 
No
 
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