Welcome to Arthritis Assist

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20% of survey complete.

Thanks for registering to speak with an Arthritis Assist Peer-Mentor! Please answer a few questions to tell us a little bit about yourself and why you'd like to speak with a Peer-Mentor. This helps us to match you with one of our volunteers as best we can!

The questionnaire may take around 10 minutes to complete.

By completing this survey, you consent to your responses being shared with the Peer-Mentor you will be matched with for the purposes of providing peer support. You also accept the terms of our Privacy Policy and Collection Statement.

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* 1. Please enter your first name

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* 2. Please enter your surname

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* 3. What is your postcode?

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* 4. What gender do you identify as?

Woman

Man

Prefer to Self Describe

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* 5. What is your date of birth?

DD/MM/YYYY

Date

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

Yes, Aboriginal

Yes, Torres Strait Islander

Yes, Aboriginal and Torres Strait Islander

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* 7. How did you hear about this service?

Online search engines (e.g. Google)

Social Media

Arthritis Qld or NSW E-newsletter

Family or friends

Health professional or health organisation

Other (please specify)

Welcome to Arthritis Assist

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* 1. Please enter your first name

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* 2. Please enter your surname

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* 3. What is your postcode?

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* 4. What gender do you identify as?

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* 5. What is your date of birth?

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

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* 7. How did you hear about this service?

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* 8. Please enter the phone number you would like a Peer-Mentor to call you on

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* 9. Please enter the email address you'd like us to communicate with you on