SHAG - Survey

Senior Housing Assistance Group is the northwest's largest organization dedicated to providing affordable rental apartments for age and income qualified persons typically aged 62 years and older.

As part of our ongoing commitment to the people of Washington State we conduct periodic research to assist us in better understanding future housing needs and preferences. Thank you for taking a moment to complete this short survey.

Please tell us about you!
Name:
Address:
Unit Number:
City:
State:
Zip Code:
Telephone:
Email:
Are You:	Married: Single:
Age:
Your approximate annual household income:
Do you currently:	Own home Rent apt
Do you drive:	Yes No

The following questions consider your future living choices:
Indicate your preferred area for a future residence (check all that apply)
Seattle:	Downtown South North
King County:	North South East
Snohomish County:
Pierce County:
Other(please indicate)
Are you considering moving to a new residence?	please indicate within the next number of months

What type of residence/community would you consider: (check all that apply)
Seniors only
Multi-family apartments
Single family/town home/condo
Short term rental
Long term lease
Ownership

Indicate your future housing preference (check all that apply)
Independent Living
Apartment rental
studio
1 bedrm
2 bedrm
Condominium/town-home
1 bedrm
2 bedrm
Single family home
Care Facility
Congregate/limited personal care
studio
1 bdrm
2 bdrm
Assisted living
studio
1 bdrm
2 bdrm
Continuing care facility
studio
1 bdrm
2 bdrm
Maximum monthly rate you would expect to pay for your choice above:	per month

This section looks at services that may interest you
Score the following list from 1 – 10 (by typing in the box next to each item) with 1 being your lowest and 10 your highest choice, if “Seniors Only” was selected above. (example: elevators = 1; on-site chapel = 2; access-controlled building =3, etc)
Access-controlled building:
Elevators:
Transportation provided:
Social programs/activities:
Live in resident manager:
Parking preference:
On-site Chapel:
On-site medical offices:
Medication reminders:
Personal Care/Nursing Assistance:

Indicate your preference for the additional services
Housekeeping services:
Dining/Daily meal preparation:	Meals/day :
Laundry preference:

Thank you for your assistance

SHAG communities are located in Bellingham , Lynnwood , Kirkland , Seattle,
Renton , Kent , Federal Way , Auburn , Puyallup , Lakewood , Tacoma , Olympia .

For more information please call SHAG at 1-888-450-7564.