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* 1. Please select the most relevant category as it relates to you – choose one

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* 2. Which local area are you based?

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* 4. Please assist us by providing the following information - What gender are you?

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* 5. Please assist us by providing the following information - Do you have a disability?

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* 6. In order to provide targeted support in response to an adverse event, Council would like to know what adverse events have impacted your community

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* 7. Can you please tell us about the impacts that the adverse event had on your community?

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* 8. In the future, which adverse event are you most concerned could impact your community?

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* 9. How has your community responded to an adverse event in the past?

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* 10. What worked well for you and your community  in response to the adverse event?

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* 11. What strengths and capacities does your community have that can be used to support prevention, preparedness, response and recovery?

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* 12. What do you think should be the priorities of council in response to an adverse event? Select your top 3

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* 13. How well prepared do you feel for the next adverse event?

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* 14. What is the one thing that you want for your community to strengthen capacity to deal with an adverse event?

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* 15. Is there anything else you would like to share with us to assist your community in dealing with an adverse event?

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