This is My Home

This survey is for adults living with an intellectual disability and their parents/guardians. We want to serve you better by finding out what you need and want from supported accommodation. By completing the survey you will stand a change to WIN an iPad 32GB for completing this 4 minute survey. Be ensured that all answers you provide will be kept in the strictest confidentiality. Please complete as the person requiring supported accommodation. Winners will be announced 01 October 2018, be sure to complete the survey before then.

Are you male or female?

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* 1. Are you male or female?

What is you age?

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* 2. What is you age?

Where do you currently live?

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* 3. Where do you currently live?

In what type of supported accommodation do you want to live in?

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* 4. In what type of supported accommodation do you want to live in?

Why do you need or want supported accommodation?

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* 5. Why do you need or want supported accommodation?

What is important when moving to supported accommodation?

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* 6. What is important when moving to supported accommodation?

What features do you want in the house

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* 7. What features do you want in the house

Where would you look for information about supported accommodation services?

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* 8. Where would you look for information about supported accommodation services?

Do you have an NDIS plan?

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* 9. Do you have an NDIS plan?

Do you have Supported Independent Living funding in you plan?

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* 10. Do you have Supported Independent Living funding in you plan?

Do you want Challenge to contact you about our accommodation options? Please enter you phone number or email.

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* 11. Do you want Challenge to contact you about our accommodation options? Please enter you phone number or email.

Please choose you favorite accommodation  picture

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* 12. Please choose you favorite accommodation  picture

Do you have any other comments, questions, or concerns?

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* 13. Do you have any other comments, questions, or concerns?

Please provide your contact details where we can contact you if you are one of the winners.

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* 14. Please provide your contact details where we can contact you if you are one of the winners.

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