Health Consumers NSW, the Older Women’s Network and the Association for the Wellbeing of Children in Healthcare are interested to find out about people’s experience of ageism in health care. We know people can experience ageism anywhere, but this survey is about ageism in health care.

Being treated differently because of your age can happen to ANYONE and we would like to hear from people of all ages and all genders (male, female and others) to let us know about your experience.

This survey should only take about 5 minutes to complete and all responses are anonymous (except if you give us permission to share your story).

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* 1. What is your age?

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* 2. Are you:

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* 3. Which best describes you?

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* 4. I live in:

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* 5. Have you ever felt like you received different treatment (compared to other patients) from a health service because of your age?

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* 6. Has anyone in your surroundings ever felt like they received different treatment from a health service because of their age?

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