Older Adults and Families 1st Time User Survey

Older Adults and Caregivers Survey

Nevada Interprofessional Healthy Aging Network (NIHAN) is supported through federal funding from HRSA, DHS, grant U1QHP33069, Geriatrics Workforce Enhancement Program (GWEP). To assist us in planning future training/workshops, please complete the following survey. This simple survey will take approximately 3 minutes. We appreciate your assistance in meeting our HRSA data collection and reporting requirements. Collected demographic information will only be used for reporting purposes.

 


This survey form is for new users to the Nihan.care website. If you already have an account, please login here.

 

Step 1 of 2

After completion of the survey, an account will be created for you along with access to all of the training modules and material.

Name*
Of the following, which describes you the best?*

Please select your current employment status.*
How did you hear about this training?*

Please select your employment location. Please select ALL that apply. (e.g., William Bee Ririe Clinic is checked for all as primary care setting, medically underserved community, and rural area)*
Note: MUC If it is Cleveland Clinic, Mission Pine, Sunrise Hospital, UNLV, UMC, VSHospital, VMSN. NOT MUC if it is Mountain View Hospital
What is your gender?*
How old are you?*
What's your race?*

What's your ethnicity?*
What is your marital status?*
What is your educational level?*

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