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* 1. Which of the following best describe you (Choose all responses that apply)

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* 2. What type(s) of disability do you or someone you care for have?

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* 3. How would you rate the accessibility of the following Council facilities and services for people with disability?

  Very accessible Somewhat accessible Not very accessible Not at all accessible Don't know
Information about council events facilities and services (including Council website)
Council Customer Service
Libraries
Sporting facilities
Civic and Community Events
Parks and Playgrounds
Public Restrooms
Footpaths
Road Crossings
Council car parks
Council run events

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* 4. Which Council facilities, events or services that are not accessible should be prioritised by Council?

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* 5. Do you have any suggestions on how Council services, facilities and events could be made more accessible?

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* 6. What barriers have you experienced when you are accessing council facilities,  events and services?

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* 7. Do you have any suggestions on how Council could address these barriers?

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* 8. How could council improve the employment and volunteer opportunities for people with disability within Council?

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* 9. Do you have any further comments or suggestions that will help Council form the Disability Inclusion Action Plan goals?

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* 10. My age range is:

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* 11. My gender is:

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* 12. Are you of Aboriginal or Torres Strait Islander origin?

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* 13. Do you speak a language other than English at home?

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