Darwin Family Day

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* 1. What is your name?

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* 2. What is your email address?

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* 3. What is your phone number?

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* 4. Will you be attending the Family Day on Saturday June 22nd?

Yes

No

No but would like to attend one in the future

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* 5. Which of the following topics would you like to discuss at the Family Day? (Please select at least 3)

NDIS Eligibility

How to apply for the NDIS?

What is covered under the NDIS?

NDIS Planning Meeting

Deaf Identity

Auslan

NDIS Services

Talk to a parent of a deaf/ hard of hearing child

How to support a deaf/ hard of hearing child

Other (please specify)

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* 6. What is your postcode?

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* 7. Do you identify as Aboriginal or Torres Strait Islander?

Yes

No

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* 8. What is the preferred communication method of your deaf / hard of hearing child?

Auslan / other sign language

Spoken Language

Both

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* 9. What languages does your family use at home?

English

Auslan

Other (please specify)

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* 10. How often does your family have contact with other families with deaf children?

Daily

Weekly

Monthly

Never

Other (please specify)