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Colac Area Health Partnering with Consumers with Disability.

People with Disability and their experience with Colac Area Health.

We want to hear about your experiences. If you identify as having disability, or care for someone with disability please complete this survey. You can complete the survey once for each person with disability. If you are completing this survey for a person you care for, please answer with their experiences.
1.Do you identify as having disability?
2.Do you care for a person with disability?
3.What is your age group (or the age of the person you care for)?
4.Which of the following do you identify with?
5.Has the person with disability used Colac Area Health services in the past 12 months?
6.Which services were accessed at Colac Area Health?
7.How satisfied were you with the services received at Colac Area Health?
very satisfied
somewhat satisfied
Neutral
not satisfied
Very dissatisfied
8.If you did not access services at Colac Area Health, what reasons apply?
9.Would you like to talk about your experiences at Colac Area Health with the Disability Liaison Officer?
10.What is the best way to make contact with you?
11.Please provide your contact details so that Disability Liaison Officer can contact you.