Having a voice for YOUR Magazine Survey

Women's Health Grampians and the Wimmera Primary Care Partnership together with Wimmera Health Care Group, Wimmera Uniting Care and the Wimmera Regional Sports Assembly want to hear from you! The following information is being collected to inform a new magazine that will be developed locally by YOU and YOUR PEERS in conjunction with the Wimmera Mail Times. The information from the survey is confidential & will only be used by the agencies working on this project.

Thank you - EVERY VOICE COUNTS!

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1. Town

Town

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2. Age

Age 12-15

16-19

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3. Briefly describe the best thing about your school/community.

Briefly describe the best thing about your school/community.

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4. Do you believe that regardless of social background, culture, religion, sexuality or ability all girls have a right to feel equal/belong?

Do you believe that regardless of social background, culture, religion, sexuality or ability all girls have a right to feel equal/belong? Strongly agree

Slightly agree

Disagree

Slightly disagree

Strongly disagree

Other (please specify)

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5. Which of the following are important to you? Tick all that apply.

Which of the following are important to you? Tick all that apply. Career advice

Employment support/mentoring

Family

Contraception

Educational support/mentoring

Friends

Breast awareness and checks

Financial independance

Pap tests

Tertiary/further education

Unintended pregnancy/termination

Peer pressures

Pregnancy counselling

Positive body image/self esteem

Sexually Transmitted Infections

Volunteering

Other (please specify)

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6. Which of the following do you believe are issues within your community? Tick all that apply.

Which of the following do you believe are issues within your community? Tick all that apply. Cybersafety (including mobile phones ie; picture messaging, social networking, privacy etc)

Limited arts/cultural options

Bullying

Cyberbullying (including mobile phones)

Illegal/illicit drugs

Educational options

Alcohol related conflict/s

Limited entertainment options

Gender equality

Housing/emergency accommodation

Local employment options

Binge drinking

Negativity around body image

Underage drinking

Sporting options

Transport

Media influences

Mental health (anxiety, depression, sleep disorders etc)

Problem gambling

Racism

Other risk taking behaviour

Risky sexual behaviour

Smoking

Unemployment

Violence

Other (please specify)

7. Where do you get your information relating to the above questions? Tick all that apply

Where do you get your information relating to the above questions? Tick all that apply Books

Counsellor

Doctor

Friends

Hospital/Bush Nursing Centre

Magazines

Nurse (including school nurse)

Online

Parents/guardian

Psychologist

School teacher

Siblings/other family

Telephone

Youth worker

Other (please specify)

8. When faced with worries or concerns about yourself or others can you get help when needed?

	Options
Always	*When faced with worries or concerns about yourself or others can you get help when needed? Always Options
Occasionally	Occasionally Options
I do not seek help	I do not seek help Options

Other (please specify)

9. What makes it hard for you to seek health and/or support services? Tick all that apply

What makes it hard for you to seek health and/or support services? Tick all that apply Confidentiality in a small community

Cost

Distance to service

Knowledge of whats available

Not comfortable with service providers

Self confidence

Transport

Waiting time

Other (please specify)

10. Do you believe you have something to offer a local magazine specifically for girls?

If yes please briefly describe your area of interest ie; Arts, music, poetry, photography, sport, writing etc.PLEASE PROVIDE CONTACT DETAILS

If no thank you for your time completing this survey!

Do you believe you have something to offer a local magazine specifically for girls? If yes please briefly describe your area of interest ie; Arts, music, poetry, photography, sport, writing etc.PLEASE PROVIDE CONTACT DETAILS If no thank you for your time completing this survey!

Having a voice for YOUR Magazine
Exit this survey

1. Default Section

*
1. Town

*
2. Age

*
3. Briefly describe the best thing about your school/community.

*
4. Do you believe that regardless of social background, culture, religion, sexuality or ability all girls have a right to feel equal/belong?

*
5. Which of the following are important to you? Tick all that apply.

*
6. Which of the following do you believe are issues within your community? Tick all that apply.

7. Where do you get your information relating to the above questions? Tick all that apply

8. When faced with worries or concerns about yourself or others can you get help when needed?

9. What makes it hard for you to seek health and/or support services? Tick all that apply

10. Do you believe you have something to offer a local magazine specifically for girls?

If yes please briefly describe your area of interest ie; Arts, music, poetry, photography, sport, writing etc.PLEASE PROVIDE CONTACT DETAILS

If no thank you for your time completing this survey!

Having a voice for YOUR MagazineExit this survey

1. Default Section

*1. Town

*2. Age

*3. Briefly describe the best thing about your school/community.

*4. Do you believe that regardless of social background, culture, religion, sexuality or ability all girls have a right to feel equal/belong?

*5. Which of the following are important to you? Tick all that apply.

*6. Which of the following do you believe are issues within your community? Tick all that apply.

7. Where do you get your information relating to the above questions? Tick all that apply

8. When faced with worries or concerns about yourself or others can you get help when needed?

9. What makes it hard for you to seek health and/or support services? Tick all that apply

10. Do you believe you have something to offer a local magazine specifically for girls? If yes please briefly describe your area of interest ie; Arts, music, poetry, photography, sport, writing etc.PLEASE PROVIDE CONTACT DETAILS If no thank you for your time completing this survey!

Having a voice for YOUR Magazine
Exit this survey

*
1. Town

*
2. Age

*
3. Briefly describe the best thing about your school/community.

*
4. Do you believe that regardless of social background, culture, religion, sexuality or ability all girls have a right to feel equal/belong?

*
5. Which of the following are important to you? Tick all that apply.

*
6. Which of the following do you believe are issues within your community? Tick all that apply.

10. Do you believe you have something to offer a local magazine specifically for girls?

If yes please briefly describe your area of interest ie; Arts, music, poetry, photography, sport, writing etc.PLEASE PROVIDE CONTACT DETAILS

If no thank you for your time completing this survey!