This free survey is powered by
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We are conducting a brief survey of persons 65 years of age and older regarding knowledge and access to information about home modification and Occupational therapy in the Montgomery area.
 
 
 
Are there any barriers in your home currently that make it difficult for you or those who live in your home to move around freely from room to room? Please describe.
   
 
 
 
During an average week how much time do you spend in your home each day?
 
0-6 hours
 
7-12hours
 
13-18 hours
 
19-24 hours
 
 
 
What is your preferred method of receiving information?
 
Word of mouth
 
Internet
 
TV
 
Magazines
 
 
 
In your own words, what do you believe is the job of an Occupational Therapist?
   
 
 
 
Thank you.