Ballina Local Mental Health Forum is looking at the idea of developing a wellbeing and support service to Ballina to support the wellbeing of our community. We aim to provide an inclusive service open to all members of the Ballina Community and surrounding areas.

We need your input to help us develop a service that the people of Ballina would like to access. Please fill in the following questionnaire which is anonymous.

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* 1. Age Group: Please tick as appropriate

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* 2. Gender: Please tick as appropriate:

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* 3. What type of wellbeing supports would  you like to see available in this centre?

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* 4. Please tick any services you would feel would be appropriate

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* 5. What type of support would be of benefit to the community’s wellbeing in the EVENING time?

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* 6. Please tick any services you would feel would be appropriate

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* 7. What barriers might prevent you from seeking support for your wellbeing?

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* 8. Please tick all of which may apply

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* 9. How did you receive this survey? (e.g. friend, social media, email, etc). Please specify

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