Refugee / Migrant Polio Survivor Survey

Polio Australia is seeking to understand more about the younger polio survivor population.

We are committed to supporting younger polio survivors, and are eager to build a community of ‘Next Generation’ Polio Survivors. We would appreciate your support in completing a brief survey to help us understand how to better direct our efforts.

The survey should take approximately 6 minutes to complete.
It is anonymous, however there is an option at the end of the survey to provide us with your contact details to help us further.

If you have any questions regarding this survey, please contact Paul Cavendish (paul@polioaustralia.org.au / 0466 719 013).

We thank you in advance for your time to consider the needs of polio survivors and how our organisation can better assist them.

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* 1. For us to better understand any demographic trends, please list your location (e.g. "Canberra"):

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* 2. Over the past two years, the number of people I saw who had, or were suspected to have had Poliomyelitis was:

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* 3. Please write a number of “polio survivors” you have seen who had, or were suspected to have had Poliomyelitis from the following country of origins in the Middle East:

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* 4. Please write a number of “polio survivors” you have seen who had, or were suspected to have had Poliomyelitis from the following country of origins in Africa:

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* 5. Please write a number of “polio survivors” you have seen who had, or were suspected to have had Poliomyelitis from the following country of origins in Asia:

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* 6. Considering the polio survivor population, you have worked with, what have been the key health issues that are often having an impact (choose all that may apply):

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* 7. What are the most significant barriers for providing information to refugee/migrant polio survivors (choose all that may apply):

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* 8. What information would be most helpful to support the polio survivor population (choose all that may apply):

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* 9. What support services have you assisted polio survivors with:

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* 10. If you are interested in contributing further information via a focus group session, please complete your details below.

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