Staying active and on your feet (SAOYF) booklet Question Title * 1. Your Professional Role Assistant in Nursing Nurse Community Nurse Exercise Physiologist Occupational Therapist Physiotherapist Physical Activity Provider Other (please specify) OK Question Title * 2. What is your work setting? Acute Subacute Rehabilitation Outpatients Community Residential Aged care Independent Living Other (please specify) OK Question Title * 3. When do you provide clients/patients with the SAOYF booklet Pre-admission At admission On discharge Community Team visit (e.g. Nurses/PT/OT) Stepping On program April Falls Activities Other (please specify) OK Question Title * 4. Who receives the SAOYF booklet? All clients/patients over 65 years Clients/Patients over 65 years who are at high risk of falls Clients/Patients with a falls risk factor Other (please specify) OK Question Title * 5. How do you use the SAOYF booklet? Provide the booklet to clients/patients Go through the booklet with the client/patient Use the booklet as part of a class/treatment Other (please specify) OK Question Title * 6. How useful do you find this booklet for patients/families/carers? Extremely useful Somewhat useful Useful Not so useful Not at all useful Comment OK Question Title * 7. Approximately how many copies of this booklet do you hand out per month? 1-25 26-50 50-100 >100 Actual Number if known OK Question Title * 8. Please provide any feedback you have had on the booklet from clients/patients? OK Question Title * 9. Do you have any other feedback on this booklet OK DONE