Dementia-Friendly Community Survey

Survey questionnaire was adopted from Dementia Australia’s ‘CREATING DEMENTIA-FRIENDLY COMMUNITIES: A TOOLKIT FOR LOCAL GOVERNMENT’ 

1. What is your gender?
2. What is your age?
3. Do you currently experience physical or cognitive difficulties? (Please tick all that apply)
4.In a typical week do you live?
5. How often do you get out of the house?
Options are limited to
Options are limited to
255
Options are limited to
Options are limited to
Options are limited to 1
12. Would you like to participate in a focus group to explore the results of this survey further?
255