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Please take our survey...

At SeniorMag, we are always interested in finding out more about our readers so that we can determine what kinds of services to develop and help our advertisers understand who seniors are and what they are all about. 

We hope that you will take just a couple of minutes to fill in the form below and then click the "Submit" button at the bottom.  No personal information is collected and your response to this survey

How fast is your connection to the Internet?
Which describes your age range? 
Which describes your income range? 
Enter your two letter state code ( ex. New York = NY) 

Which best describes your community where you live:

Urban Suburban Rural
Which best describes your marital status: 
Which more accurately describes your home setting:

How would you best define your financial ability to retire?

Very comfortable - No needs, no wants, no worries
Somewhat comfortable - No major concerns but cannot do it all
Generally comfortable - No worries but need to be careful
Finances get somewhat sticky from time to time
Money is always tight - no wiggle room whatsoever
Always short - often go without some things I need

Aside from Medicare, do you maintain any health insurance?
Do you own a private policy that provides for long-term care?
Do you have a will?

Where are your children living? (pick as many as apply)

No children - does not apply to me

One or more children living...

  within 10 miles within 500 miles
  within 20 miles within 1000 miles
  within 50 miles within 1500 miles
  within 100 miles within 2000 miles
  within 200 miles within 3000 miles
  within 300 miles in excess of 3000 miles

What services do you currently subscribe to?  (pick as many as apply)

None In-home personal services
Maid service Dry-cleaning p/u and delivery
Yard service In-home medical care
Pool maintenance Laundry services
Meal preparation Errand service
Meal delivery Driver service
Pharmacy delivery Companion services
Grocery delivery Financial assistance
Handyman services

Which services do you plan to employ within the next 2 years.  (pick as many as apply)

None In-home personal services
Maid service Dry-cleaning p/u and delivery
Yard service In-home medical care
Pool maintenance Laundry services
Meal preparation Errand service
Meal delivery Driver service
Pharmacy delivery Companion services
Grocery delivery Financial assistance
Handyman services

Which services would you opt for if money were not an issue? (pick as many as apply)

None In-home personal services
Maid service Dry-cleaning p/u and delivery
Yard service In-home medical care
Pool maintenance Laundry services
Meal preparation Errand service
Meal delivery Driver service
Pharmacy delivery Companion services
Grocery delivery Financial assistance
Handyman services

Do you plan or expect to move within the next 5 years?

Choose
I don't plan to move
I plan to move into a smaller house
I plan to move into a condo
I plan to move into an apartment
I plan to move in with one of my kids
I plan to move in with other family
I plan to move into an assisted living unit

What activities do you often do in an average day?  (pick as many as apply)

Work at place of employment Listen to radio
Meet friends for social time Read book
Talk to friends/family on telephone Cook
Read magazine or newspaper Garden
Pray/worship/devotions Exercise
Check out web sites Check email
Play computer games Go shopping
Watch television Go to church
Creative activity Go to a movie
Listen to music Hobby activity

 

How often do you travel out of town?

If you do travel, what purposes do you travel for?  (pick as many as apply)

I don't travel Vacation
Business Visit family/friends
Recreation


 

 

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