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title_survey

Name: *required
Email: *required
Phone: *required

1. How many years of experience in dementia care have you had?
2. What was your last position in dementia care?
            How long were you in that position?
3. Do you have personal caregiving experience?
4. If yes, who was the care recipient? (check all that apply)
Parent   Spouse   Sibling   Other Family Member   Non-Relative  
5. What is your homecare experience?
6. Are you employed?
7. Are you able to invest between $5,000 and $10,000 in this opportunity?
8. Do you have business experience?
9. What type business experience?
10. Have you experience in training or teaching others?
11. How much do you enjoy teaching?
12. What type of training was it?
13. How do you envision being a coach licensee? (check all that apply)
Career   PT Work   A Business  
14. Describe yourself in 300 characters or less.
15. Gender
16. How did you learn about the StilMeeā„¢ Coaching Opportunity?




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"My coach was extremely helpful and a pleasure to work with. We gained so much valuable information."







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