We are asking residents to have their say on the availability of home based community services in the Snowy Monaro region. The information collected through this survey will assist all providers to understand your needs now and into the future. We understand that there is an unmet need in the
area of home based services, inclusive of support and transportation for people with disability and the aged. Your feedback is important so we can understand where the gaps exist.

Participation in this survey can be anonymous. This survey will close on by COB Friday 9 September 2022.

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* 1. Name (optional)

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* 2. Where do you reside (town)?

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* 3. How old are you?

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* 4. What is the age range of the person you are completing this survey for?

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* 5. Are you (please tick)

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* 6. What is your employment status?

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* 7. Are you completing this related to aged care, disability or other?

Please tell us about your most regular trip, other than travelling for work or education:

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* 8. What is the town or major centre you travel to or visit the most, other than going to work (e.g. Jindabyne, Cooma or Canberra)?

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* 9. How often do you make your most regular trip that is not for work?

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* 10. Why do you make your most regular trip, other than work?

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* 11. Are there trips you would like to make, but can’t because of lack of transport?

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* 12. Which services were you needing to access?

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* 13. Which of these reasons would you like to use transport for, but can’t? (tick all that apply)

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* 14. Have you ever used Community Transport services provided by Council?

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* 15. If ‘yes’ what was the purpose of your Community Transport trip?

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* 16. Are you currently receiving any services in the Snowy Monaro region? (tick all that apply)

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* 17. Do you feel that the services you currently receive are meeting your needs?

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* 18. Please describe why you chose this rating:

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* 19. Have you tried to access services in the past, but have not been able to secure a provider for home based support?

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* 20. If ‘Yes’ who have you tried and are you on a waitlist?

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* 21. Are you familiar with "My Aged Care"?

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* 22. If ‘No’ would you like further information as to how to access?

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* 23. If ‘Yes’ are you registered with ‘My Aged Care’?

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* 24. Are you on a waitlist through "My Aged Care"?

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* 25. In planning ahead, are your responses in the survey reflective of your current or anticipated need?
Are you in need of services:

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* 26. Do you have access and support to get onto the internet?

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* 27. If ‘Yes’ do you require assistance to access ‘My Aged Care’?

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* 28. If ‘No’ would you like assistance to register with ‘My Aged Care’?

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* 29. Are there things you used to enjoy doing, that you can no longer access?
If yes, what sort of things and what would assist you to reengage?

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* 30. How do you like to receive information about aged care and community services that are available to you?

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* 31. Has this survey captured your concerns? If not, please provide further information.

Thank you for taking the time to complete this survey!

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