Skip to content
Carer Experience Survey
About You
*
How long have you been receiving care and support from this organisation?
(Required.)
Less than 6 months
Less than 1 year
1-2 years
3-4 years
5-6 years
Unsure
*
Your gender:
(Required.)
Female
Male
X (indeterminate/Intersex/Unspecified)
*
Your age is:
(Required.)
Less than 50
50-54 years
55-59 years
60-64 years
65-69 years
70-74 years
75-79 years
80-84 years
85-89 years
90-94 years
95-99 years
100+
*
Your relationship to the person receiving care and service:
(Required.)
*
Please specify your ethnicitiy origin:
(Required.)