Florida Senior Center Survey

Florida Senior Center Survey

Many elders and their families turn to the Department of Elder Affairs for information, resources, and services to help fill their unmet needs.

Please take a moment to complete this short survey to help us fulfill our mission to promote the well-being, safety, and independence of Florida's seniors, their families, and caregivers.

Senior Center Contact Information

Name of Senior Center*

What type of facility is this?*

Please select all that apply.

Multipurpose Senior Center (as stated in 430.901, F.S.)

Congregate Meal Site

Food Bank

Please indicate if this is a new entry or an update from a previous entry.*

New

Updated

County*

Select or enter value

Physical Street Address*

City*

State*

Zip Code*

Mailing Address*

Is the mailing address the same as the physical address?

Select or enter value

Mailing Address

Mailing Street Address*

Mailing City*

Mailing State*

Mailing Zip Code*

Senior Center Main Phone Number*

Senior Center Website*

Senior Center General Email*

Senior Center Point of Contact (POC)*

POC Phone Number*

Phone

POC email address*

Senior Center Program and Services

Services and Programs:*

Educational Classes (languages, computers, etc.)

Health & Wellness

Art Classes

Recreational Programs

Caregiver Programs

Community Organizations

Special Events and Projects

Congregate Meal Site

Other

Please specify other*

Senior Center Needs*

Please note any needs your senior center may have, e.g., volunteers, meal delivery, transportation, etc. If there are no needs, please write none.

Additional Comments

Please note any additional information you would like to share about your senior center.

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