Department of Communities, Disability Services and Seniors

Sample survey of older people

Use this survey tool to begin your baseline assessment process. Use it again during the evaluation process. Compare your results.

This survey asks about your perceptions of age-friendliness. Please respond to the statements and answer the questions in your own words.

My form

An asterisk (This field is required) indicates a required field.

Outdoor spaces and buildings
Our outdoor spaces and buildings make a positive contribution to older people.:
Older people feel safe walking around.:
Transport
The public transport system is affordable.:
The public transport system is reliable.:
The public transport system is accessible.:
Housing
Affordable housing designed to meet older people’s changing needs is available.:
Well-located housing designed to meet older people’s changing needs is available.:
Social participation
Older people are supported to participate in events and social activities that support their needs.:
Respect and social inclusion
Older people are respected in the community.:
Older people are included in community activities and events.:
Civic participation and employment
Older people are supported to work in paid employment.:
Older people are supported to take up volunteer positions if they choose to.:
Older people are involved in decision-making processes that affect them.:
Communication and information
Older people are provided with useful information.:
Older people are provided with timely information.:
Older people are provided with accessible information.:
Community support and health services.
Community support and health services are available to enable older people to continue to live in their own homes.:

Thank you for completing our survey