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Senior Placement Solution for Assisted Living Charlotte, Gastonia Mooresville service area and storefront.

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Local Knowledge of Assisted Living, Memory Care, Independent Living and In-Home Care Operators in Shelby, Kings Mountain, Cherryville, Gastonia, Lincolnton, Charlotte, Lake Norman, Mooresville, Huntersville, and surrounding counties. 

Discover the best Long-Term Care solution for you or loved one today!

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    <title>Senior Living Quiz</title>
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<div id="form-wrapper" class="bg-white shadow-lg rounded-lg w-full max-w-xl p-6 md:p-8">
    <h1 class="text-2xl md:text-3xl font-bold text-center mb-4 text-gray-800">Personalized Senior Living Quiz</h1>
    <p class="text-center text-gray-600 mb-6">Answer a few questions to find the best options for you.</p>

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            <div class="space-y-3">
                <label class="block p-4 border rounded-lg cursor-pointer hover:bg-blue-50"><input type="radio" name="who_for" value="myself" class="mr-3"> Myself</label>
                <label class="block p-4 border rounded-lg cursor-pointer hover:bg-blue-50"><input type="radio" name="who_for" value="loved_one" class="mr-3"> A loved one</label>
                <label class="block p-4 border rounded-lg cursor-pointer hover:bg-blue-50"><input type="radio" name="who_for" value="other" class="mr-3"> Other</label>
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            <h2 class="text-xl font-semibold mb-4 text-gray-700">What type of care is needed?</h2>
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                <label class="block p-4 border rounded-lg cursor-pointer hover:bg-blue-50"><input type="checkbox" name="care_type" value="independent_living" class="mr-3"> Independent Living</label>
                <label class="block p-4 border rounded-lg cursor-pointer hover:bg-blue-50"><input type="checkbox" name="care_type" value="assisted_living" class="mr-3"> Assisted Living</label>
                <label class="block p-4 border rounded-lg cursor-pointer hover:bg-blue-50"><input type="checkbox" name="care_type" value="memory_care" class="mr-3"> Memory Care</label>
                <label class="block p-4 border rounded-lg cursor-pointer hover:bg-blue-50"><input type="checkbox" name="care_type" value="home_care" class="mr-3"> Home Care</label>
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            <h2 class="text-xl font-semibold mb-4 text-gray-700">What is your monthly budget for senior living?</h2>
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                <label class="block p-4 border rounded-lg cursor-pointer hover:bg-blue-50"><input type="radio" name="budget" value="under_3000" class="mr-3"> Under $3,000</label>
                <label class="block p-4 border rounded-lg cursor-pointer hover:bg-blue-50"><input type="radio" name="budget" value="3000-6000" class="mr-3"> $3,000 - $6,000</label>
                <label class="block p-4 border rounded-lg cursor-pointer hover:bg-blue-50"><input type="radio" name="budget" value="over_6000" class="mr-3"> Over $6,000</label>
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        <div class="question" data-step="4">
            <h2 class="text-xl font-semibold mb-4 text-gray-700">What is your preferred location?</h2>
            <input type="text" name="location" class="w-full p-3 border rounded-lg" placeholder="Enter city or zip code" required>
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        <div class="question" data-step="5">
            <h2 class="text-xl font-semibold mb-4 text-gray-700">Finally, how can we reach you?</h2>
            <div class="space-y-4">
                <div>
                    <label for="fullName" class="block mb-2 font-semibold text-gray-700">Full Name</label>
                    <input type="text" id="fullName" name="name" class="w-full p-3 border rounded-lg" placeholder="Your Name" required>
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                <div>
                    <label for="phone" class="block mb-2 font-semibold text-gray-700">Phone Number</label>
                    <input type="tel" id="phone" name="phone" class="w-full p-3 border rounded-lg" placeholder="(555) 123-4567" required>
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            <button type="button" id="next-btn" class="bg-blue-600 text-white px-6 py-2 rounded-lg hover:bg-blue-700 flex-shrink-0 disabled:bg-gray-400 disabled:cursor-not-allowed">Next</button>
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        <h2 class="text-2xl font-bold text-green-600">Thank You!</h2>
        <p class="text-gray-700 mt-2">Your information has been submitted. We will be in touch shortly.</p>
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