PSCB In Good Company - Social Peer Group Expression of Interest

Yes. You’re ready to be In Good Company!

Thank you for your interest in joining In Good Company, our social peer group for people with physical disabilities.

Please note: the location of the Sydney-based peer group will be determined by the suburb most convenient to the majority of the group members.

Whether you have always lived with physical disability, or have recently acquired disability, In Good Company creates breathing space, where you can simply relax, be yourself and enjoy good company with others who truly understand your journey.

About YOU

The following questions will help us understand more about who you are, what you're hoping to gain from our group and how you might contribute to our collective growth. We are very much looking forward to getting to know you!

Note: PDCN greatly values your privacy. The information you provide here will be kept confidential and used to help us select the peer group members for In Good Company, as spaces are limited.

For more information, our Privacy Policy is available on our website; https://www.pdcnsw.org.au/privacy-policy/

Let’s get started!

Contact Information

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* 1. First Name:

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* 2. Last Name:

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* 3. Phone Number:

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* 4. Email Address:

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* 5. Confirm email Address:

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* 6. Suburb:

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* 7. Postcode:

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* 8. Gender:

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* 9. Age Group:

10-19

20-29

30-39

40-49

50-59

60-69

Over 70

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* 10. I identify as:

CALD

ATSI

LGBTQIA+

Regional/Remote

None of the above

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* 11. I have Physical Disability

Yes

Please specify

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* 12. I have non-physical Disabilities

Yes

Please specify

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* 13. To get around Sydney I:

Drive myself

Am driven by my support worker/informal support

Take Public Transport

Require/Prefer Wheelchair accessible taxis

Other

Please specify

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* 14. Which days/times would work best for you to attend monthly meetings? (Select all that apply)

Weekday Mornings

Weekday afternoons

Weekday evenings

All the above

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* 15. In Good Company will grow stronger with regular participation. We’d love to know your capacity to attend monthly meetings:

Yes, I can Commit to regular attendance

I can attend most meetings but may occasionally miss some

My schedule is unpredictable, but I'll try my best

I'm not sure at this time

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* 16. Preferred contact method:

Phone

Text

Any of the above

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* 17. I get to socialise in person:

Every day

2-3 times per week

Once a week

Once a month

Less than once a month

Tell us more if you like:

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* 18. I am happy with the amount of socialising I have in my life:

Yes

Depends

Tell us more if you like:

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