Senior Survey

Over the past couple of years, especially during the pandemic, I have found that there seems to be services I felt were missing for our seniors. I’m hoping this survey would help confirm or identify those needs. As we grow older, our needs changes as well. So please, take a few minutes to fill out this online form.

Or, download the PDF, fill our and return it to my office at city hall.

City Hall – Mayor’s Office
2 Fifteenth Street
Watervliet, NY 12189
Cpatricelli@Watervliet.com

Download Fillable PDF

Contact Information

In order to help you better, please provide your contact information so we may reach out to you. This information will NOT be shared with anyone.
Name
Address

Senior Survey

Things I need help with (check all that apply):
What is your living situation?
Are you homebound?
Are you a caregiver?
Do you need meals brought to you?
What age range do you fall in?
Are you disabled?
Would you be willing to volunteer?
Do you currently attend the Senior Center?
If not, would you be willing to join?