Aging in Reston Survey

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?

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?

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.

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