Are you 55 years or older?*
How did you hear about this program?*
What are some of concerns/problems older people experience?*
What do you think are some of the positive things about growing older?*
How do you feel about your own aging process?*
Why are you interested in participating in the program?*
How do you imagine participation in Senior Peer Counseling could influence your personal life?*
In what way do you believe one’s behavior and attitudes have an effect on one’s health?*
What qualities help one become an effective peer counselor?*
Describe any experience you have with counseling or health education.*
Describe some of your previous employment/volunteer activities.*
Please explain any health problems that would limit your involvement in the program or might help you understand another’s situation better.*
What form of transportation would you be using?*
What else would you like us to know about you?
