Thank you for your interest in the Cognitive Kitchen program! The following questions will gather information to confirm you are eligible for the program. Once you have confirmed your eligibility, you will be navigated to the next page.

The remainder of the survey will gather information that will help the program coordinator get to know you. You will also be able to select which offering of the program you are interested in and see the scheduled dates and locations for upcoming program offerings (if available).

Lastly, information about the optional research component is available on the last page of the survey, where you will have the opportunity to select whether or not you would like to participate in the research activities. You are welcome to participate in the program without participating in research but please ensure you click through to the end of the survey to indicate your preferences.

The information you share will be stored securely. General demographic information may be presented as part of the research findings. However, no personal or identifying information will be stored with research data.

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* Please provide your contact information for follow-up about the program.

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* What is your birth date? (YYYY-MM-DD)

Please note: To be eligible to register, you must 1) be either 55+ OR a care partner of a person living with dementia, and 2) live in Saskatchewan.

The program is also open to people living with dementia who wish to attend with their care partners. To best monitor participant numbers, we ask that care partners complete this survey and indicate whether the person they care for is interested in attending. The program coordinator will then follow up to gather more information and ask whether this person is interested in participating in the research component.

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* Please confirm you are living in Saskatchewan and either a care partner of someone living with dementia, or an adult 55 and over.

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