HearingQueer support survey
www.voicesvic.org.au

1.

1. Which of the following do you identify as?

Which of the following do you identify as? Lesbian

Gay

Transexual

Bisexual

Intersexual

Other

2. In what year where you born?

In what year where you born?

3. What is your area/post-code?

What is your area/post-code? State:
Post Code:

4. Are you interested in participating in a support group for people in the Queer community who have experience with hearing voices, seeing visison, or other unusual experiences?

Are you interested in participating in a support group for people in the Queer community who have experience with hearing voices, seeing visison, or other unusual experiences?

5. What would you like to gain through participating in this group?

What would you like to gain through participating in this group?

6. Would you be interested in gender specific groups with this program?

Would you be interested in gender specific groups with this program? Yes

7. Could you tell us a little about what it's like for you to hear voices, see visions or have other unusual experiences?

Could you tell us a little about what it's like for you to hear voices, see visions or have other unusual experiences?

8. We want to share personal experiences like yours on our website - to help others know they are not alone. Would you give us consent to use some of your comments from this survey on our website? All comments posted will be anonymous. This is totally optional.

We want to share personal experiences like yours on our website - to help others know they are not alone. Would you give us consent to use some of your comments from this survey on our website? All comments posted will be anonymous. This is totally optional. Yes, I give consent to anonymously use my comments on the Voices Vic website.

9. Do you have any other comments or suggestions?

Do you have any other comments or suggestions?

10. If you would like us to send you more information about our activities, please give your email below:

If you would like us to send you more information about our activities, please give your email below:

HearingQueer support surveywww.voicesvic.org.au

1.

HearingQueer support survey
www.voicesvic.org.au