Dementia & Alzheimer's Support Group Interest Survey
Are you caring for a loved one experiencing memory loss?  We are exploring whether there is community interst in a support group for care givers.  This would offer a time to gather to share experiences and recieve support and potentially some guidance on managing care and dementia related behaviors.  We are also hoping to simultaneously offer a program for the individuals with Dementia.  

*The presence of a facilitator for the support group and another for the program for those with dementia will be dependent on grant funding and access to qualified individuals.  

This initial survey is to gather data to help us determine interest and the times that work best.

Please email Lyn at whitefieldpubliclibrary2@gmail.com if you have questions.
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Name of caregiver *
Name of individual with Dementia
Please indicate which program(s) are of interest
(check all that apply)
 *
Required
I would attend:
(check all that apply)
 *
Required
Please indicate best day of the week
(check all that apply)
 *
Required
Please indicate best time of the day
(check all that apply)
 *
Required
Please indicate preferred length of program *
email address *
Please add me to the email subscriber list for Whitefield Public Library
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