1. How long have you been a caregiver?
2. You are the caregiver for
3. Age of the person you are caring for
4. Type of disability (check all that apply):
5. Do you currently have formal support (respite care, paid housekeeping or homecare, other professional services, etc) for helping you with caregiving?
6. Do you currently have informal support (family, friends, other unpaid services) for helping you with caregiving?