FOI 24/25-1267
DOCUMENT 3
National Disability Insurance Scheme
Outcomes Framework
Short Form Questionnaires
Family Questions for participants aged 25 and over
v2.0
1
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Family Questions for participants aged 25
and over
In this first section, I will ask you some background questions.
Family member/carer information
Question
Answer
1. Please enter the participant’s NDIS ID
Free text (check for valid number of
number
characters?)
2. What is your relationship to the
☐ Mother
participant?
☐ Father
☐ Grandmother
☐ Grandfather
☐ Sister
☐ Brother
☐ Other family member
☐ Carer
☐ Other (please specify):
3. Are you currently working in a paid
☐ Yes
job?
☐ No
4. Is it permanent or casual?
☐ Permanent
☐ Casual
5a. What is the industry of employment? a) Accommodation and Food Services
b) Administrative and Support Services
c) Agriculture, Forestry and Fishing
d) Arts and Recreation Services
e) Construction
f) Education and Training
g) Electricity, Gas, Water and Waste
Services
h) Financial and Insurance Services
i) Health Care and Social Assistance
j) Information Media and
Telecommunications
k) Manufacturing
l) Mining
m) Professional, Scientific and Technical
Services
n) Public Administration and Safety
o) Rental, Hiring and Real Estate Services
p) Retail Trade
q) Transport, Postal and Warehousing
r) Wholesale Trade
s) Other services (please specify)
5b. What is your job or role title?
Text field
6. What are the typical hours per week
☐ 0 hours
worked (range)?
☐ More than 0 but less than 8 hours
☐ 8 hours to less than 15 hours
☐ 15 hours to less than 30 hours
2
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Question
Answer ☐ 30 or more hours
7. What is your annual income, before
☐ $0-$9,999
tax and other deductions?
Include all
☐ $10,000-$19,999
sources (e.g. wages, investments and
☐ $20,000-$29,999
Government pensions and benefits)
☐ $30,000-$39,999
☐ $40,000-$59,999
☐ $60,000-$79,999
☐ $80,000-$99,999
☐ $100,000-$149,999
☐ $150,000-$199,999
☐ $200,000+
☐ Not disclosed
8. What is the annual income of your
☐ $0-$9,999
household, before tax and other
☐ $10,000-$19,999
deductions?
Include all sources (e.g.
☐ $20,000-$29,999
wages, investments and Government
☐ $30,000-$39,999
pensions and benefits)
☐ $40,000-$59,999
☐ $60,000-$79,999
☐ $80,000-$99,999
☐ $100,000-$149,999
☐ $150,000-$199,999
☐ $200,000+
☐ Not disclosed
9. Please specify whether you currently receive any government benefits.
Please select
Yes or No for each option.
Carer payment
Yes/ No
Carer allowance
Yes/ No
Other (please specify):
Free text
10. Are you currently studying?
☐ Yes, full time
☐ Yes, part time
☐ No
3
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Thank you for that. I would now like to cover some questions and statements about your
confidence in advocating for the participant.
Domain 1: Families know their rights and advocate effectively for
their family member with disability
#
Statement/question
Response options
1 I am able to identify the needs a) Yes
of my family member with
b) I have some difficulty
disability and my family and
c) I have a great deal of difficulty
know how to access available
services and supports to meet
those needs
2 I am able to advocate (stand
a) Yes
up) for my family member: I
b) I have some difficulty
am able to speak up if we
c) I have a great deal of difficulty
have issues or problems with
accessing supports
3 Has the NDIS helped you to ☐ Yes, a lot
know your rights and
☐ Yes, a bit
advocate effectively?
☐ No, not at al
☐ N/A (did not need help in this area)
The next few questions/statements focus on your relationships and support networks.
Domain 2: Families have the support they need to care
#
Question/statement
Response options
1 I have friends and family that I see as a) Yes
often as I like
b) No
2 I have people who I can ask for
a) Yes
practical help as often as I need
b) No
3 I have people who I can ask to
a) Yes
support my family member with
b) No
disability as often as I need
4 I have people who I can ask for
a) Yes
emotional support as often as I need b) No
5 I get the services and supports I need a) Yes
to care for my family member with
b) I would like more support
disability
c) I would like different support
d) I would like support at different times
6 Has the NDIS improved the level of ☐ Yes, a lot
support for your family?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in this area)
4
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Let’s now consider your experiences with getting access to services, programs and
activities. I will now read out three statements relating to your engagement with services and
supports.
Domain 3: Families are able to gain access to desired services,
programs, and activities in their community
#
Statement/question
Response options
1 I feel that the services my family member with a) Yes
disability and my family use listen to me
b) Not very much
c) Not at all
2 I feel in control in selecting services and
a) Yes
supports that meet the needs of my family
b) I have some difficulty
member with disability and my family
c) I have a great deal of difficulty
3 The services my family member with disability a) Yes
and my family receive meet our needs
b) No
4 Has the NDIS helped you to access services,
☐ Yes, a lot
programs and activities in the community?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in this
area)
The next few questions are about planning for the future.
Domain 4: Families have succession plans
#
Statement/question
Response options
1
Have you made plans for when you are no longer
a) Yes
able to care for your family member with disability?
b) I have begun
c) No
2
Have you asked for assistance from any of the following?
Please answer Yes or No
for each option.
Yes
No
Siblings of the person with disability
☐
☐
Your extended family
☐
☐
Your friends
☐
☐
The friends of your family member
☐
☐
Service providers
☐
☐
Professionals
☐
☐
Support workers
☐
☐
Other (please specify):
3
Has the NDIS helped you with preparing for the
☐ Yes, a lot
future support of your family member?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in
this area)
5
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Finally, we want to know a bit about your health and wellbeing. There are both statements
and questions.
Domain 5 Families enjoy health and wellbeing
#
Statement/question
Response options
1 In general, my health is
a) Excellent
b) Very good
c) Good
d) Fair
e) Poor
2 I feel that my family member gets the a) Strongly agree
support he/she needs
b) Agree
c) Neutral
d) Disagree
e) Strongly disagree
3 Family who provide informal care to
a) Yes
my family member with disability are
b) No, they would like to work more
able to work as much as they want
4 The barriers to working more are
a) Situation of family member with
(choose one or more options):
disability
b) Availability of jobs
c) Available jobs do not have sufficient
flexibility (e.g. of hours)
d) Other (please specify)
5 Has the NDIS improved your health
☐ Yes, a lot
and wel being?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in this area)
Thank you for answering these questions. If you have any further comments, I can record
them now.
Question
Answer
Any comments?
Text field
6
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DOCUMENT 4
National Disability Insurance Scheme
Outcomes Framework
Short Form Questionnaires
Participants from 0 to before starting school
v3.0
1
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Participants from 0 to before starting
school
In this first section, I will ask you some background questions.
Participant information
Question
Answer
1. NDIS Participant ID number
Pre-populated NDIS participant number
2. Who does the child currently live with?
☐ With parents
☐ With other family members
☐ With people not related to participant
(e.g. foster carers)
☐ Other, please specify:
3. What type of housing does the child
☐ Private home: owned by family/carers
currently live in?
☐ Private home: rented from private
landlord
☐ Private home: rented from public
authority
☐ Other, please specify:
4. What is the annual income of the child’s
☐ $0-$9,999
household, before tax and other
☐ $10,000-$19,999
deductions?
(Don't include the income of
☐ $20,000-$29,999
people the participant only shares
☐ $30,000-$39,999
accommodation with, e.g. in a group home) ☐ $40,000-$59,999
☐ $60,000-$79,999
☐ $80,000-$99,999
☐ $100,000-$149,999
☐ $150,000-$199,999
☐ $200,000+
☐ Not disclosed
5. Is compensation being sought, or has
☐ Yes
compensation previously been sought, in
☐ No
relation to the child's disability?
These next set of questions relate to the child’s development, use of specialist services and
autonomy.
Domain 1: Daily living
#
Statement/Question
Answer options
1
Do you have any concerns about your child’s
development in the following areas?
Please
answer Yes or No for each area.
• Gross motor skills (e.g. crawling, standing, walking, ☐ Yes ☐ No
catching a ball)
• Fine motor skills (e.g. drawing, stacking blocks,
☐ Yes ☐ No
pincer grasp)
2
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#
Statement/Question
Answer options
• Self-care (e.g. washing or eating)
☐ Yes ☐ No
• Eating/ Feeding (e.g. chewing, swallowing,
☐ Yes ☐ No
transitioning to table foods)
• Social interaction (e.g. playing with peers,
☐ Yes ☐ No
interacting with others, separating from parents,
behaviours such as biting, hitting, frequent
tantrums)
• Language/Communication (e.g. following
☐ Yes ☐ No
directions, speaking, expressing themselves,
participating in conversations)
• Cognitive development (e.g. understanding
☐ Yes ☐ No
concepts, problem solving)
• Sensory processing (e.g. concentration, responses ☐ Yes ☐ No
to changes in routine or certain textures, dislikes
bath or grooming activities)
• Please specify any other areas of concern:
Free text
2
My child uses specialist services (e.g. speech
☐ Yes
pathology, occupational therapy) that assist their
☐ No
learning and development
3
These services help my child gain the skills
☐ Yes
she/he needs to participate in everyday life (e.g.
☐ No
go to preschool)
4
These services support me to assist my child
☐ Yes
☐ No
5
Has the NDIS improved your child’s
☐ Yes, a lot
development?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help
in this area)
6
Has the NDIS improved your child’s access to
☐ Yes, a lot
specialist services?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help
in this area)
Domain 2: Choice and Control
#
Statement/Question
Answer options
1
My child is able to tell me what he/she wants ☐ Yes, without assistance
☐ Yes, with assistance
☐ No
2
Has the NDIS helped increase your child’s
☐ Yes, a lot
ability to communicate what they want?
☐ Yes, a bit
☐ No, not at al
3
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☐ N/A (did not need help in this
area)
These next questions and statements centre on relationships, including friendships and the
family dynamic.
Domain 3: Relationships
#
Statement/Question
Answer options
1 My child gets along with his/her
☐ Yes
brother(s)/sister(s)
☐ No
☐ No brothers or sisters
2 My child can make friends with people outside
☐ Yes
the family
☐ With some people
☐ No
3 My child joins me when I complete tasks at
☐ Often
home
☐ Sometimes
☐ Never
4 My child joins me when I complete tasks outside ☐ Often
the home (e.g. shopping, sport)
☐ Sometimes
☐ Never
5 My child fits in with the everyday life of the
☐ Yes
family
☐ No
6 Has the NDIS improved how your child fits
☐ Yes, a lot
into family life?
☐ Yes, a bit
☐ No, not at all
☐ N/A (did not need help in this
area)
Finally, I would like to understand a little more about your child’s social and community
involvement.
Domain 4: Social, community and civic participation
#
Question
Answer options
1 Do you use any form of childcare? ☐ Yes
☐ No
2 Please specify which of the fol owing types of childcare you use, and whether you
use them when you and/or your partner are at work, or when you are not at work.
Please select one answer per childcare type.
Use while
Use while
Both
Neither
we’re at
we’re not at
work
work
• The child's brother or sister
☐
☐
☐
☐
• Another relative who lives with you
☐
☐
☐
☐
(paid or unpaid)
4
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#
Question
Answer options
• Another relative who doesn't live
☐
☐
☐
☐
with you (paid or unpaid)
• A friend or neighbour (caring for the
☐
☐
☐
☐
child either at your home or in their
home; paid or unpaid)
• A nanny or babysitter who is paid to
☐
☐
☐
☐
come to your home
• A nanny or babysitter who is paid to
☐
☐
☐
☐
care for your child in their home
• Family day care, long day care, any
☐
☐
☐
☐
other care at a Child Care Centre
• The child goes to your (or your
☐
☐
☐
☐
partner's) work
3 My child has friends that he/she
☐ Yes
enjoys playing with
☐ No
4 These friends are at
(choose all
☐ Preschool
that apply):
☐ Playgroup
☐ Social or family gatherings (e.g. children
of friends or extended family)
☐ Other community activities
☐ Other (please specify):
5 My child participates in age
☐ A few times a week
appropriate community, cultural or
☐ About once a week
religious activities
☐ Once every two weeks
☐ About once a month
☐ Less than once a month
☐ Never
6 At these activities, I think my child
☐ Welcomed
is (
choose one option):
☐ Actively included
☐ Mostly an observer
☐ Tolerated
☐ Made to feel unwelcome
☐ Is present but not real y a part of the group
7 I would like my child to be more
☐ Yes
involved in community activities
☐ No
8 The barriers to my child being
☐ My child's disability (e.g. ability to
involved in community activities are communicate)
(choose all that apply):
☐ Other children are not welcoming
☐ Other families are not welcoming
☐ I am too busy
☐ Transport
☐ Cost
☐ Other (please specify):
5
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#
Question
Answer options
9 Has the NDIS improved how your ☐ Yes, a lot
child fits into community life?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in this area)
Conclusion
Thank you for answering these questions. To close this out I just need to record (confirm)
who completed the questionnaire. You may also provide some comments if you wish.
Question
Answer options
Who responded to the questions?
☐ The participant’s mother
☐ The participant’s father
☐ The participant’s grandmother
☐ The participant’s grandfather
☐ Other, please specify:
Any comments?
6
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DOCUMENT 5
National Disability Insurance Scheme
Outcomes Framework
Short Form Questionnaires
Participant from starting school to age 14
v3.0
1
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Participants from starting school to age 14
In this first section, I will ask you some background questions.
Participant information
Question
Answer
1. NDIS Participant ID number
Pre-populated NDIS participant number
2. Who does the child currently live
☐ With parents
with?
☐ With other family members
☐ With people not related to participant (e.g.
foster carers)
☐ Other, please specify:
3. What type of housing does the child
☐ Private home: owned by family/carers
currently live in?
☐ Private home: rented from private landlord
☐ Private home: rented from public authority
☐ Other, please specify:
4. Does the child currently have a job? ☐ Yes
(including a part time job outside
☐ No
school hours) 5. Please describe the type of work
Free text
(e.g. serving in a restaurant,
newspaper round, office
administration, babysitting) 6. What is the usual number of hours
☐ 0 hours
worked per week?
☐ More than 0 but less than 8 hours
☐ 8 hours to less than 15 hours
☐ 15 or more hours
7. What is the usual weekly income
☐ $0
(before tax and other deductions)?
☐ $0-$49 per week
☐ $50-$99 per week
☐ $100 or more per week
☐ Not disclosed
8. What is the annual income of the
☐ $0-$9,999
child’s household, before tax and other ☐ $10,000-$19,999
deductions?
(Don't include the income ☐ $20,000-$29,999
of people the participant only shares
☐ $30,000-$39,999
accommodation with, e.g. in a group
☐ $40,000-$59,999
home)
☐ $60,000-$79,999
☐ $80,000-$99,999
☐ $100,000-$149,999
☐ $150,000-$199,999
☐ $200,000+
☐ Not disclosed
9. Is compensation being sought, or
☐ Yes
has compensation previously been
☐ No
sought, in relation to the child's
disability?
2
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These next set of questions relate to the child’s development and level of autonomy.
Domain 1: Daily living
#
Statement/Question
Answer
1
My child is developing functional, learning and ☐ Not very well
coping skills that are appropriate to his/her
☐ Pretty well
ability and circumstances
☐ Very well
2
Most of the time my child manages his/her
☐ Not very well
emotions
☐ Pretty well
☐ Very well
3
Most of the time my child is able to do tasks at ☐ Not very well
home, at school and in the community that a
☐ Pretty well
child of the same age would be expected to be ☐ Very well
able to do
4
My child is becoming more independent
☐ Yes
☐ No
5
My child spends time away from us (his
☐ Yes
parents) other than at school
☐ No
6
When our child spends time away from us, he/she spends time with
(please
answer Yes or No for each option):
Yes
No
Extended family
☐
☐
Family friends
☐
☐
Child’s friends
☐
☐
In group activities with local peers
☐
☐
In activities with other children with disability
☐
☐
In a respite house
☐
☐
Other (please specify):
7
My child spends time with friends without an
☐ Frequently
adult present
☐ Occasionally
☐ On one occasion
☐ Never
8
My child has a genuine say in decisions about
☐ Yes, most decisions
him/her
☐ Some decisions
☐ No
9
Has the NDIS helped your child to become
☐ Yes, a lot
more independent?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in
this area)
3
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I would now like to understand a little bit about your child’s learning and education
experience.
Domain 2: Lifelong learning
#
Statement/Question
Answer
1 My child attends school
(includes home
☐ Yes
schooling)
☐ No
2 My child's current (or most recently
☒ Kindergarten or equivalent
completed) school year is:
☐ Year 1
☐ Year 2
☐ Year 3
☐ Year 4
☐ Year 5
☐ Year 6
☐ Year 7
☐ Year 8
☐ Year 9
☐ Year 10
☐ Year 11 or above
3 My child is enrolled in
☐ A mainstream class
☐ A support class
☐ A special school
☐ A school/class for gifted/talented
children
☐ Home schooling
4 I think that my child is learning at school
☐ Almost always
☐ Usually
☐ Sometimes
☐ Not usually
☐ Almost never
5 I think that my child is happy at school
☐ Almost always
☐ Usually
☐ Sometimes
☐ Not usually
☐ Almost never
6 Has your child been involved in the following co-curricular activities at school?
Please answer Yes or No for each activity.
Yes
No
In school plays/ concerts
☐
☐
In school clubs
☐
☐
In sporting teams
☐
☐
As a prefect
☐
☐
As a member of the student representative
☐
☐
4
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#
Statement/Question
Answer
council
As a buddy or mentor to other students
☐
☐
Other (please specify):
7 Has your child ever been suspended from
☐ Yes
school?
☐ No
8 Has the NDIS improved your child’s access to ☐ Yes, a lot
education?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in this
area)
These next questions and statements centre on relationships, including friendships and the
family dynamic.
Domain 3: Relationships
#
Statement/Question
Answer
1 My child gets along well with his/her
☐ Yes
brother(s)/sister(s)
☐ No
☐ No brothers or sisters
2 My child can make friends with people
☐ Yes
outside the family
☐ With some people
☐ No
3 There is enough time each week for all
☐ Yes
members of my family to get their needs ☐ No
met
4 My child fits well into the everyday life of ☐ Often
the family
☐ Sometimes
☐ Never
5 When you need to go out, which of the
☐ Siblings
following options do you use to look after ☐ Extended family
your child?
Choose all that apply:
☐ Friends
☐ He/she is able to stay alone
☐ Privately recruited babysitter
☐ NDIS individualised support
☐ Respite centre
☐ We never go out without our child
6 Are you happy with that arrangement?
☐ Yes
☐ No
7 My child has friends that he/she enjoys
☐ Yes
spending time with
☐ No
8 These friends are
Choose all that apply
☐ At school
5
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#
Statement/Question
Answer
☐ Outside school
☐ Online
☐ Other, please specify
9 Has the NDIS improved your child’s
☐ Yes, a lot
relationships with family and friends?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in this area)
Finally, I would like to understand a little more about your child’s social and community
involvement.
Domain 4: Social, community and civic participation
#
Statement/Question
Answer
1 During school holidays I use the ☐ Parents provide care
following holiday care (
choose all ☐ Mainstream school holiday program
that apply):
☐ School holiday program for children with
disability
☐ NDIS funded support
☐ Grandparents
☐ Other family
☐ Friends
☐ Able to stay by themselves
☐ Other (please specify):
2 My child is happy with this
☐ Most of the time
choice/ these choices
☐ Some of the time
☐ Rarely
☐ Never
3 After school and on the weekend ☐ Gets together with friends
my child (
choose all that apply):
☐ Is involved in mainstream sport, clubs, or
other group activities
☐ Is involved in sport, clubs, or other group
activities with children with disability
☐ None of the above
4 In these activities, I feel my child ☐ Welcomed
is:
☐ Actively included
☐ Mostly an observer
☐ Tolerated
☐ Made to feel unwelcome
☐ Present but is not really part of the group
5 I would like my child to have
☐ Yes
more opportunity to be involved
☐ No
in activities with other children
6
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#
Statement/Question
Answer
6 The barriers to my child being
☐ My child’s disability (e.g. ability to
more involved with other children communicate)
are (
choose all that apply):
☐ Other children are not welcoming
☐ Other families are not welcoming
☐ I am too busy
☐ Transport
☐ Cost
☐ Other (please specify):
7 Has the NDIS improved your
☐ Yes, a lot
child’s social and recreational
☐ Yes, a bit
life?
☐ No, not at al
☐ N/A (did not need help in this area)
Conclusion
Thank you for answering these questions. To close this out I just need to record (confirm)
who completed the questionnaire. You may also provide some comments if you wish.
Question
Answer options
Who responded to the
☐ The participant on their own
questions?
☐ The participant with assistance from another person (e.g.
family member, friend)
☐ The participant’s mother
☐ The participant’s father
☐ The participant’s grandmother
☐ The participant’s grandfather
☐ Other, please specify:
Any comments?
7
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DOCUMENT 6
National Disability Insurance Scheme
Outcomes Framework
Short Form Questionnaires
Participant aged 15 to 24
v3.0
1
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Participants aged 15 to 24
In this first section, I will ask you some background questions.
Participant information
Question
Answer
1. NDIS Participant ID number
Pre-populated NDIS participant number
2. What level of school have you
☐ None
completed?
☐ Year 7 or below
☐ Year 8
☐ Year 9
☐ Year 10
☐ Year 11
☐ Year 12 or above
3. What is the highest level of post-
☐ None
school qualification you have completed? ☐ TAFE Certificate I-IV
☐ Diploma or Advanced Diploma
☐ Graduate Certificate or Graduate Diploma
☐ Bachelor degree
☐ Postgraduate degree (e.g. Masters, PhD)
☐ Other (please specify):
4. Who do you currently live with?
☐ Alone
☐ Parents
☐ Spouse/partner
☐ Spouse/partner and child(ren)
☐ Child(ren)
☐ Other family members
☐ People not related to me
☐ Other, please specify:
5. What are your current housing
☐ Private home: owned by self/family
arrangements?
☐ Private home: rented from private landlord
☐ Private home: rented from public authority
☐ Large residential (20+ people)
☐ Small residential (<20 people)
☐ Hostel
☐ Aboriginal or Torres Strait Islander
community residence
☐ Supported accommodation
☐ Boarding house/private hotel
☐ Short-term crisis
☐ Temporary shelter (homeless)
☐ Nursing home/aged care facility
☐ Other, please specify:
6. What type of employment activities do ☐ Do not participate (not working and not
you currently attend/participate in?
looking for work)
☐ Job seeking (on your own or with an
employment service)
2
Page 34 of 58
FOI 24/25-1267
Question
Answer
☐ Employment in the open employment
market with ful award wages
☐ Employment in the open employment
market at less than minimum wage, i.e.
Supported Wage System
☐ Employment with an Australian Disability
Enterprise
☐ Pre-vocational training
☐ Australian Apprenticeship
☐ Work experience
☐ Self-employed
☐ Other (please specify)
7a. What is the industry of employment? a) Accommodation and Food Services
b) Administrative and Support Services
c) Agriculture, Forestry and Fishing
d) Arts and Recreation Services
e) Construction
f) Education and Training
g) Electricity, Gas, Water and Waste Services
h) Financial and Insurance Services
i) Health Care and Social Assistance
j) Information Media and
Telecommunications
k) Manufacturing
l) Mining
m) Professional, Scientific and Technical
Services
n) Public Administration and Safety
o) Rental, Hiring and Real Estate Services
p) Retail Trade
q) Transport, Postal and Warehousing
r) Wholesale Trade
s) Other services (please specify)
7b. What is your job or role title?
Text field
8. What is the typical number of hours
☐ 0 hours
you work per week (range)?
☐ More than 0 but less than 8 hours
☐ 8 hours to less than 15 hours
☐ 15 hours to less than 30 hours
☐ 30 or more hours
9. What is your annual income, before
☐ $0-$9,999
tax and other deductions?
Include all
☐ $10,000-$19,999
sources, such as wages, investments
☐ $20,000-$29,999
and Government pensions and benefits.
☐ $30,000-$39,999
☐ $40,000-$59,999
☐ $60,000-$79,999
☐ $80,000-$99,999
☐ $100,000-$149,999
☐ $150,000-$199,999
☐ $200,000+
☐ Not disclosed
3
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FOI 24/25-1267
Question
Answer
10. What is the annual income of your
☐ $0-$9,999
household, before tax and other
☐ $10,000-$19,999
deductions?
Include income from all
☐ $20,000-$29,999
sources, such as wages, investments
☐ $30,000-$39,999
and Government pensions and benefits.
☐ $40,000-$59,999
(Don't include the income of people you
☐ $60,000-$79,999
only share accommodation with, e.g. in a ☐ $80,000-$99,999
group home)
☐ $100,000-$149,999
☐ $150,000-$199,999
☐ $200,000+
☐ Not disclosed
11. What educational activities are you
☐ Not studying
currently participating in?
☐ Secondary (high) school – mainstream
class
☐ Secondary (high) school - special class in
mainstream school
☐ Special school
☐ Pre-apprenticeship vocational training
☐ Australian Apprenticeship
☐ TAFE college or other post-secondary
training col ege
☐ University course
☐ Other (please specify)
12. Are you currently studying full time or ☐ Full time
part time?
☐ Part time
13. Are you seeking or have you
☐ Yes
previously sought compensation related ☐ No
to your injury/disability?
4
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These next question are about the level of independence, control and choice you have in
your life.
Domain 1: Choice and Control
#
Question
Answer
1 Do you have more
a) Yes
independence/control over your life
b) No, because of factors
related to
than you did 2 years ago?
my disability (e.g. degenerative
condition)
c) No, because of factors
unrelated to
my disability
2 Are you happy with the level of
a) Yes
independence/control you have now?
b) No
3 Do you make more decisions in your
a) Yes and it's about right
life than you did 2 years ago?
b) Yes and I would like to make more
c) No it’s the same
d) No I make fewer decisions
4 What involvement do/did you have in
a) I made the decisions
planning for your life after your school b) I had some input into the decisions
years?
c) Someone else made the decisions
d) I haven’t started planning yet
5 Do you choose who supports you?
a) Yes I choose
b) Sometimes I have a say
c) No, someone else chooses
6 Do you choose what you do each day? a) Yes I choose
b) Sometimes I have a say
c) No, someone else chooses
7 Who makes most decisions in your
a) I do
life?
b) My family
c) My friends
d) My service providers
e) Others (please specify):
8 Do you feel able to advocate (stand
a) Yes
up) for yourself? That is, do you feel
b) No
able to speak up if you have issues or
problems with accessing supports?
9 Have you ever participated in a self-
a) Yes
advocacy group meeting, conference,
b) No, I had the opportunity but chose
or event?
not to participate
c) No, I have not had the opportunity
to participate
10 Do you want more choice and control
a) Yes
in your life?
b) No
11 Has the NDIS helped you have more
☐ Yes, a lot
choices and more control over your life? ☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in this area)
5
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We will now move onto some questions about your daily activities – including activities you
need support with and thinking about any support that you do receive. We will cover eight (8)
activity areas.
Domain 2: Daily living activities
#
Question
Answer
Logic, rules & validation
Activity area 1: Domestic tasks
1
Do you need support to do domestic
a) Yes
Yes (go to 2)
tasks (e.g. shopping, cooking,
b) No
No (go to 5)
cleaning, meal preparation)?
2
Do you get support for domestic
a) Yes
Yes (go to 3)
tasks?
b) No
No (go to 5)
3
Does the support you receive meet your a) Yes
needs?
b) No
4
Does the support you currently receive a) Yes
enable you to perform the tasks
b) No
yourself as much as possible?
Activity area 2: Personal care
5
Do you need support with personal
a) Yes
Yes (go to 6)
care (e.g. washing yourself, dressing)? b) No
No (go to 9)
6
Do you get support with personal care a) Yes
Yes (go to 7)
(e.g. washing yourself, dressing)?
b) No
No (go to 9)
7
Does the support you receive meet your a) Yes
needs?
b) No
8
Does the support you currently receive a) Yes
enable you to care for yourself as
b) No
much as possible?
Activity area 3: Travel & transport
9
Do you need support for travel &
a) Yes
Yes (go to 10)
transport?
b) No
No (go to 13)
10
Do you get support for travel &
a) Yes
Yes (go to 11)
transport?
b) No
No (go to 13)
11
Does the support you receive meet your a) Yes
needs?
b) No
12
Does the support you currently receive a) Yes
al ow you to travel by yourself as much b) No
as possible?
Activity area 4: Communication
13
Do you need support to communicate
a) Yes
Yes (go to 14)
with other people?
b) No
No (go to 17)
14
Do you get support for communicating a) Yes
Yes (go to 15)
with others?
b) No
No (go to 17)
15
Does the support you receive meet your a) Yes
needs?
b) No
16
Does the support you currently receive a) Yes
enable you to communicate as
b) No
independently as possible?
6
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FOI 24/25-1267
#
Question
Answer
Logic, rules & validation
Activity area 5: Getting out of the house
17
Do you need support for getting out of a) Yes
Yes (go to 18)
the house?
b) No
No (go to 21)
18
Do you get support for getting out of
a) Yes
Yes (go to 19)
the house?
b) No
No (go to 21)
19
Does the support you receive meet your a) Yes
needs?
b) No
20
Does the support you currently receive a) Yes
enable you to get out of the house with b) No
as little assistance as possible?
Activity area 6: Dealing with finances/money
21
Do you need support with dealing with a) Yes
Yes (go to 22)
your finances/money?
b) No
No (go to 25)
22
Do you get support with dealing with
a) Yes
Yes (go to 23)
your finances/money?
b) No
No (go to 25)
23
Does the support you receive meet your a) Yes
needs?
b) No
24
Does the support you currently receive a) Yes
enable you to manage finances/money b) No
by yourself where possible?
Activity area 7: Reading and/or writing
25
Do you need support with reading
a) Yes
Yes (go to 26)
and/or writing?
b) No
No (go to 29)
26
Do you get support with reading
a) Yes
Yes (go to 27)
and/or writing?
b) No
No (go to 29)
27
Does the support you receive meet your a) Yes
needs?
b) No
28
Does the support you currently receive a) Yes
enable you to read and/or write by
b) No
yourself where possible?
Activity area 8: Technology
29
Do you need support with using
a) Yes
Yes (go to 30)
technology?
b) No
No (go to 33)
30
Do you get support with using
a) Yes
Yes (go to 31)
technology?
b) No
No (go to 33)
31
Does the support you receive meet your a) Yes
needs?
b) No
32
Does the support you currently receive a) Yes
enable you to use technology by
b) No
yourself where possible?
Overall
33
Have you ever undertaken training to
a) Yes
do more of these daily activities by
b) No
yourself?
34
Has the NDIS helped you with daily
☐ Yes, a lot
living activities?
7
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FOI 24/25-1267
#
Question
Answer
Logic, rules & validation
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not
need help in this
area)
These next questions and statements centre on relationships, including friendships and any
caring responsibilities you may have.
Domain 3: Relationships
#
Question
Answer
1
Do you have someone outside your
a) Yes, paid staff
home to cal when you need help?
b) Yes, family
(choose all that apply)
c) Yes, friends
d) No
2
Are you happy with how often you see a) Yes
your family?
b) No, I would like to see them
more
c) No, I would like to see them
less
3
Do you provide care for others?
a) Yes
b) No
4
Do you need help to continue caring
a) Yes, and I receive enough
for someone else?
assistance
b) Yes but I don’t receive enough
assistance
c) Yes, but I don’t receive any
assistance
d) No
5
Do you have friends other than family
a) Yes, people with disability
or paid staff?
b) Yes, people without disability
c) No
6
Are you happy with how often you see a) Yes
friends?
b) No, I would like to see them
more
c) No, I would like to see them
less
7
Has the NDIS helped you to meet
☐ Yes, a lot
more people?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in this
area)
8
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I would like to ask you a few questions now about your home environment.
Domain 4: Home
#
Question
Answer
1
Thinking about where you
a) Yes
currently live in relation to
b) No, I want to choose my home
your disability support needs: c) No, because of factors related to my
Are you happy with the home support needs (e.g. access, equipment,
you live in?
support)
d) No, for another reason (please specify)
2
Wil you want to live here in 5 a) Yes
years’ time?
b) No, I want to choose my home
c) No, because of factors related to my
support needs (e.g. access, equipment,
support)
d) No, for another reason (please specify)
3
What stops you from living in a) Lack of support
a home that you would
b) Lack of affordable housing
choose?
c) Lack of choice
d) Other (please specify):
4
How safe or unsafe do you
a) Very safe
feel in your home?
b) Safe
c) Neither safe nor unsafe
d) Unsafe
e) Very unsafe
5
Has your involvement with
☐ Yes, a lot
the NDIS helped you to
☐ Yes, a bit
choose a home that’s right
☐ No, not at al
for you?
☐ N/A (did not need help in this area)
9
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Life domain five (5) relates to health and wellbeing.
Domain 5: Health and wellbeing
#
Question
Answer
1
Overall, do you think that your
a) Excellent
health is excellent, very good, good, b) Very good
fair or poor?
c) Good
d) Fair
e) Poor
2
Do you have a doctor that you
a) Yes
see on a regular basis?
b) No
3
Have you had difficulty in getting
a) Yes, because of the attitudes and/or
health services?
expertise of health professionals
b) Yes, because of access issues
c) Yes, because I don’t have support
d) Yes, because I don’t have transport
d) Yes, because I can’t afford it
e) No
4
How many times have you been
a) 0
to the hospital in the last 12
b) 1
months?
c) 2
d) 3-5
e) 6+
6
Do you feel safe getting out and
a) Yes
about in your community?
b) No
7
Has your involvement with the
☐ Yes, a lot
NDIS improved your health and
☐ Yes, a bit
wel being?
☐ No, not at al
☐ N/A (did not need help in this area)
10
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I would now like to understand a little bit about your learning and education experience.
Domain 6: Lifelong learning
#
Question
Answer
1
At school, are you/were you:
a) In a regular class
b) In a support class
c) In a special school
d) A school/class for gifted/talented
children
e) Home schooled
2
At school, are you/were you actively included in the fol owing co-curricular
activities?
Please answer Yes or No for each activity.
Yes
No
In school plays and concerts
☐
☐
In school clubs
☐
☐
In sporting teams
☐
☐
As a prefect
☐
☐
As a member of the Student
☐
☐
Representative Council
As a buddy or mentor to other
☐
☐
students
Please specify any other activities you
were involved in
3
Are you stil at school (including home a) Yes
schooling)?
b) No
4
Do you get opportunities to learn new a) Yes
things?
b) No but I would like to learn
new things
c) No and that’s OK
5
Do you currently participate in
a) Yes
education, training or skil
b) No
development?
6
Where do you do this?
a) Disability education facility
b) TAFE
c) Community col ege or school
d) University
e) Other (please specify):
7
Are you in a class for students with
a) Yes
disability?
b) No
8
Is it what you want?
a) Yes
b) No
9
In the last 12 months, is there any
a) Yes, I lacked support
course or training that you wanted to
b) Yes, course requirements
do but couldn’t?
prevented me from participating
c) Yes, travel prevented me from
getting there
11
Page 43 of 58
FOI 24/25-1267
#
Question
Answer
d) Yes, the cost of courses
prevented me from participating
e) Yes, there was no suitable
course
f) Yes, other (please specify)
g) No
10
Has your involvement with the NDIS
☐ Yes, a lot
helped you to learn things you want to ☐ Yes, a bit
learn or to take courses you want to
☐ No, not at al
take?
☐ N/A (did not need help in this
area)
The following set of questions are work related.
Domain 7: Work
#
Question
Answer
1
Are you currently working in a) Yes
an unpaid job
b) No
2
Are you currently working in a) Yes
a paid job?
b) No, but I would like one
c) No and I don’t want one
3
What type of employment is a) Open employment market with ful award
it?
wages
b) Open employment market at less than
minimum wage, i.e. Supported Wage System
c) Australian Disability Enterprise
d) Australian Apprenticeship
e) Self-employed
f) Other (please specify)
4
Do you get the support you a) Yes
need to do your job?
b) No
5
Are you being assisted to
a) Yes
get a job?
b) No
6
Has your involvement with
☐ Yes, a lot
the NDIS helped you find a ☐ Yes, a bit
job that’s right for you?
☐ No, not at al
☐ N/A (did not need help in this area)
12
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Finally, I would like to understand a little more about your social and community involvement.
Domain 8: Social, community and civic participation
#
Question
Answer
1
Do you spend your free time doing
a) Yes
activities that interest you?
b) No
2
In the last 12 months, is there anything a) Yes,
that you wanted to do but couldn’t?
b) No
3
Are you currently a volunteer?
a) Yes
b) No, but I would like to
c) No, it doesn’t interest me
4
Have you been actively involved in a
a) Yes, a general community group
community, cultural or religious group
b) Yes, a group for people with a
in the last 12 months?
disability
c) No, but I would like to be
d) No and I don’t want to be
5
Do you know people in your
a) Yes
community?
b) No
6
How often do you feel you are able to
a) Al of the time
have a say with the services that
b) Most of the time
provide support for you?
c) Some of the time
d) A little of the time
e) None of the time
7
Has the NDIS helped you be more
☐ Yes, a lot
involved?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in this
area)
Thank you for answering these questions. To close this out I just need to record (confirm)
who completed the questionnaire. You may also provide some comments if you wish.
Question
Answer options
1. Are you a participant in the NDIS ☐ I am the participant
or are you taking this questionnaire ☐ I am taking the survey on someone else’s behalf
on someone else’s behalf?
2. What is your relationship to the
☐ Mother
participant?
☐ Father
☐ Spouse/partner
☐ Other family member
☐ Carer
☐ Friend
☐ Other (please specify):
3. Any comments?
13
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DOCUMENT 7
National Disability Insurance Scheme
Outcomes Framework
Short Form Questionnaires
Participant aged 25 and over
v3.0
1
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Participants aged 25 and over
In this first section, I will ask you some background questions.
Participant information
Question
Answer
1. NDIS Participant ID number
Pre-populated NDIS participant number
2. What level of school have you
☐ None
completed?
☐ Year 7 or below
☐ Year 8
☐ Year 9
☐ Year 10
☐ Year 11
☐ Year 12 or above
3. What is the highest level of post-
☐ None
school qualification you have
☐ TAFE Certificate I-IV
completed?
☐ Diploma or Advanced Diploma
☐ Graduate Certificate or Graduate Diploma
☐ Bachelor degree
☐ Postgraduate degree (e.g. Masters, PhD)
☐ Other (please specify):
4. Who do you currently live with?
☐ Alone
☐ Parents
☐ Spouse/partner
☐ Spouse/partner and child(ren)
☐ Child(ren)
☐ Other family members
☐ People not related to me
☐ Other, please specify:
5. What are your current housing
☐ Private home: owned by self/family
arrangements?
☐ Private home: rented from private landlord
☐ Private home: rented from public authority
☐ Large residential (20+ people)
☐ Small residential (<20 people)
☐ Hostel
☐ Aboriginal or Torres Strait Islander
community residence
☐ Supported accommodation
☐ Boarding house/private hotel
☐ Short-term crisis
☐ Temporary shelter (homeless)
☐ Nursing home/aged care facility
☐ Other, please specify:
6. What type of employment activities
☐ Do not participate (not working and not
do you currently attend/participate in?
looking for work)
☐ Job seeking (on your own or with an
employment service)
2
Page 47 of 58
FOI 24/25-1267
Question
Answer
☐ Employment in the open employment
market with ful award wages
☐ Employment in the open employment
market at less than minimum wage, i.e.
Supported Wage System
☐ Employment with an Australian Disability
Enterprise
☐ Pre-vocational training
☐ Australian Apprenticeship
☐ Work experience
☐ Self-employed
☐ Other (please specify)
7a. What is the industry of employment? a) Accommodation and Food Services
b) Administrative and Support Services
c) Agriculture, Forestry and Fishing
d) Arts and Recreation Services
e) Construction
f) Education and Training
g) Electricity, Gas, Water and Waste Services
h) Financial and Insurance Services
i) Health Care and Social Assistance
j) Information Media and Telecommunications
k) Manufacturing
l) Mining
m) Professional, Scientific and Technical
Services
n) Public Administration and Safety
o) Rental, Hiring and Real Estate Services
p) Retail Trade
q) Transport, Postal and Warehousing
r) Wholesale Trade
s) Other services (please specify)
7b. What is your job or role title?
Text field
8. What is the typical number of hours
☐ 0 hours
you work per week (range)?
☐ More than 0 but less than 8 hours
☐ 8 hours to less than 15 hours
☐ 15 hours to less than 30 hours
☐ 30 or more hours
9. What is your annual income, before
☐ $0-$9,999
tax and other deductions?
Include all
☐ $10,000-$19,999
sources, such as wages, investments
☐ $20,000-$29,999
and Government pensions and benefits. ☐ $30,000-$39,999
☐ $40,000-$59,999
☐ $60,000-$79,999
☐ $80,000-$99,999
☐ $100,000-$149,999
☐ $150,000-$199,999
☐ $200,000+
☐ Not disclosed
3
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FOI 24/25-1267
Question
Answer
10. What is the annual income of your
☐ $0-$9,999
household, before tax and other
☐ $10,000-$19,999
deductions?
Include income from all
☐ $20,000-$29,999
sources, such as wages, investments
☐ $30,000-$39,999
and Government pensions and benefits. ☐ $40,000-$59,999
(Don't include the income of people you
☐ $60,000-$79,999
only share accommodation with, e.g. in
☐ $80,000-$99,999
a group home)
☐ $100,000-$149,999
☐ $150,000-$199,999
☐ $200,000+
☐ Not disclosed
11. What educational activities are you
☐ Not studying
currently participating in?
☐ Secondary (high) school – mainstream
class
☐ Secondary (high) school - special class in
mainstream school
☐ Special school
☐ Pre-apprenticeship vocational training
☐ Australian Apprenticeship
☐ TAFE college or other post-secondary
training col ege
☐ University course
☐ Other (please specify):
12. Are you currently studying full time
☐ Full time
or part time?
☐ Part time
13. Are you seeking or have you
☐ Yes
previously sought compensation related ☐ No
to your injury/disability?
4
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These next question are about the level of independence, control and choice you have in
your life.
Domain 1: Choice and Control
#
Question
Answer
1
Do you choose who supports you?
a) Yes I choose
b) Sometimes I have a say
c) No, someone else chooses
2
Do you choose what you do each
a) Yes I choose
day?
b) Sometimes I have a say
c) No, someone else chooses
3
Who makes most decisions in your
a) I do
life?
b) My family
c) My friends
d) My service providers
e) Others (please specify):
4
Do you feel able to advocate (stand
a) Yes
up) for yourself? That is, do you feel
b) No
able to speak up if you have issues or
problems with accessing supports?
5
Have you ever participated in a self-
a) Yes
advocacy group meeting, conference, b) No, I had the opportunity but chose
or event?
not to participate
c) No, I have not had the opportunity
to participate
6
Do you want more choice and control a) Yes
in your life?
b) No
11 Has the NDIS helped you have more
☐ Yes, a lot
choices and more control over your
☐ Yes, a bit
life?
☐ No, not at al
☐ N/A (did not need help in this area)
5
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We will now move onto some questions about your daily activities – including activities you
need support with and thinking about any support that you do receive. We will cover eight (8)
activity areas.
Domain 2: Daily living activities
#
Question
Answer
Logic, rules & validation
Activity area 1: Domestic tasks
1
Do you need support to do domestic
a) Yes
Yes (go to 2)
tasks (e.g. shopping, cooking,
b) No
No (go to 5)
cleaning, meal preparation)?
2
Do you get support for domestic
a) Yes
Yes (go to 3)
tasks?
b) No
No (go to 5)
3
Does the support you receive meet your a) Yes
needs?
b) No
4
Does the support you currently receive a) Yes
enable you to perform the tasks
b) No
yourself as much as possible?
Activity area 2: Personal care
5
Do you need support with personal
a) Yes
Yes (go to 6)
care (e.g. washing yourself, dressing)? b) No
No (go to 9)
6
Do you get support with personal care a) Yes
Yes (go to 7)
(e.g. washing yourself, dressing)?
b) No
No (go to 9)
7
Does the support you receive meet your a) Yes
needs?
b) No
8
Does the support you currently receive a) Yes
enable you to care for yourself as
b) No
much as possible?
Activity area 3: Travel & transport
9
Do you need support for travel &
a) Yes
Yes (go to 10)
transport?
b) No
No (go to 13)
10
Do you get support for travel &
a) Yes
Yes (go to 11)
transport?
b) No
No (go to 13)
11
Does the support you receive meet your a) Yes
needs?
b) No
12
Does the support you currently receive a) Yes
al ow you to travel by yourself as much b) No
as possible?
Activity area 4: Communication
13
Do you need support to communicate
a) Yes
Yes (go to 14)
with other people?
b) No
No (go to 17)
14
Do you get support for communicating a) Yes
Yes (go to 15)
with others?
b) No
No (go to 17)
15
Does the support you receive meet your a) Yes
needs?
b) No
16
Does the support you currently receive a) Yes
enable you to communicate as
b) No
independently as possible?
6
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#
Question
Answer
Logic, rules & validation
Activity area 5: Getting out of the house
17
Do you need support for getting out of a) Yes
Yes (go to 18)
the house?
b) No
No (go to 21)
18
Do you get support for getting out of
a) Yes
Yes (go to 19)
the house?
b) No
No (go to 21)
19
Does the support you receive meet your a) Yes
needs?
b) No
20
Does the support you currently receive a) Yes
enable you to get out of the house with b) No
as little assistance as possible?
Activity area 6: Dealing with finances/money
21
Do you need support with dealing with a) Yes
Yes (go to 22)
your finances/money?
b) No
No (go to 25)
22
Do you get support with dealing with
a) Yes
Yes (go to 23)
your finances/money?
b) No
No (go to 25)
23
Does the support you receive meet your a) Yes
needs?
b) No
24
Does the support you currently receive a) Yes
enable you to manage finances/money b) No
by yourself where possible?
Activity area 7: Reading and/or writing
25
Do you need support with reading
a) Yes
Yes (go to 26)
and/or writing?
b) No
No (go to 29)
26
Do you get support with reading
a) Yes
Yes (go to 27)
and/or writing?
b) No
No (go to 29)
27
Does the support you receive meet your a) Yes
needs?
b) No
28
Does the support you currently receive a) Yes
enable you to read and/or write by
b) No
yourself where possible?
Activity area 8: Technology
29
Do you need support with using
a) Yes
Yes (go to 30)
technology?
b) No
No (go to 33)
30
Do you get support with using
a) Yes
Yes (go to 31)
technology?
b) No
No (go to 33)
31
Does the support you receive meet your a) Yes
needs?
b) No
32
Does the support you currently receive a) Yes
enable you to use technology by
b) No
yourself where possible?
Overall
33
Have you ever undertaken training to
a) Yes
do more of these daily activities by
b) No
yourself?
34
Has the NDIS helped you with daily
☐ Yes, a lot
living activities?
7
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#
Question
Answer
Logic, rules & validation
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not
need help in this
area)
These next questions and statements centre on relationships, including friendships and any
caring responsibilities you may have.
Domain 3: Relationships
#
Question
Answer
1 Do you have someone outside your home to a) Yes, paid staff
cal when you need help?
(choose all that
b) Yes, family
apply)
c) Yes, friends
d) No
2 Are you happy with how often you see your
a) Yes
family?
b) No, I would like to see them
more
c) No, I would like to see them
less
3 Do you provide care for others?
a) Yes
b) No
4 Do you need help to continue caring for
a) Yes, and I receive enough
someone else?
assistance
b) Yes but I don’t receive enough
assistance
c) Yes, but I don’t receive any
assistance
d) No
5 Do you have friends other than family or
a) Yes, people with disability
paid staff?
b) Yes, people without disability
c) No
6 Are you happy with how often you see
a) Yes
friends?
b) No, I would like to see them
more
c) No, I would like to see them
less
7 Has the NDIS helped you to meet more
☐ Yes, a lot
people?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in this
area)
8
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I would like to ask you a few questions now about your home environment.
Domain 4: Home
#
Question
Answer
1
Thinking about where you currently
a) Yes
live in relation to your disability
b) No, I want to choose my home
support needs:
c) No, because of factors related to my
Are you happy with the home you
support needs (e.g. access, equipment,
live in?
support)
d) No, for another reason (please specify):
2 Wil you want to live here in 5 years’ a) Yes
time?
b) No, I want to choose my home
c) No, because of factors related to my
support needs (e.g. access, equipment,
support)
d) No, for another reason (please specify)
3 What stops you from living in a
a) Lack of support
home that you would choose?
b) Lack of affordable housing
c) Lack of choice
d) Other (please specify):
4 How safe or unsafe do you feel in
a) Very safe
your home?
b) Safe
c) Neither safe nor unsafe
d) Unsafe
e) Very unsafe
5 Has your involvement with the NDIS ☐ Yes, a lot
helped you to choose a home that’s ☐ Yes, a bit
right for you?
☐ No, not at al
☐ N/A (did not need help in this area)
9
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Life domain five (5) relates to health and wellbeing.
Domain 5: Health and wellbeing
#
Question
Answer
1 Overall, do you think that your health is
a) Excellent
excellent, very good, good, fair or poor?
b) Very good
c) Good
d) Fair
e) Poor
2 Do you have a doctor that you see on a a) Yes
regular basis?
b) No
3 Have you had difficulty in getting
a) Yes, because of the attitudes and/or
health services?
expertise of health professionals
b) Yes, because of access issues
c) Yes, because I don’t have support
d) Yes, because I don’t have transport
d) Yes, because I can’t afford it
e) No
4 How many times have you been to the a) 0
hospital in the last 12 months?
b) 1
c) 2
d) 3-5
e) 6+
6 Do you feel safe getting out and about a) Yes
in your community?
b) No
7 Has your involvement with the NDIS
☐ Yes, a lot
improved your health and wel being?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in this area)
10
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I would now like to understand a little bit about your learning and education experience.
Domain 6: Lifelong learning
#
Question
Answer
1 Do you get opportunities to learn new a) Yes
things?
b) No but I would like to learn new things
c) No and that’s OK
2 Do you currently participate in
a) Yes
education, training or skil
b) No
development?
3 Where do you do this?
a) Disability education facility
b) TAFE
c) Community col ege or school
d) University
e) Other (please specify):
4 Are you in a class for students with
a) Yes
disability?
b) No
5 Is it what you want?
a) Yes
b) No
6 In the last 12 months, is there any
a) Yes, I lacked support
course or training that you wanted to b) Yes, course requirements prevented
do but couldn’t?
me from participating
c) Yes, travel prevented me from getting
there
d) Yes, the cost of courses prevented me
from participating
e) Yes, there was no suitable course
f) Yes, other (please specify)
g) No
7 Has your involvement with the NDIS
☐ Yes, a lot
helped you to learn things you want
☐ Yes, a bit
to learn or to take courses you want
☐ No, not at al
to take?
☐ N/A (did not need help in this area)
11
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The following set of questions are work related.
Domain 7: Work
# Question
Answer
1 Are you currently working in an
a) Yes
unpaid job
b) No
2 Are you currently working in a
a) Yes
paid job?
b) No, but I would like one
c) No and I don’t want one
3 What type of employment is it?
a) Open employment market with ful award
wages
b) Open employment market at less than
minimum wage, i.e. Supported Wage System
c) Australian Disability Enterprise
d) Australian Apprenticeship
e) Self-employed
f) Other (please specify)
4 Do you get the support you need a) Yes
to do your job?
b) No
5 Are you being assisted to get a
a) Yes
job?
b) No
6 Has your involvement with the
☐ Yes, a lot
NDIS helped you find a job that’s ☐ Yes, a bit
right for you?
☐ No, not at al
☐ N/A (did not need help in this area)
12
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Finally, I would like to understand a little more about your social and community involvement.
Domain 8: Social, community and civic participation
# Question
Answer
1 Do you spend your free time doing
a) Yes
activities that interest you?
b) No
2 In the last 12 months, is there anything a) Yes,
that you wanted to do but couldn’t?
b) No
3 Are you currently a volunteer?
a) Yes
b) No, but I would like to
c) No, it doesn’t interest me
4 Have you been actively involved in a
a) Yes, a general community group
community, cultural or religious group
b) Yes, a group for people with a
in the last 12 months?
disability
c) No, but I would like to be
d) No and I don’t want to be
5 Do you know people in your
a) Yes
community?
b) No
6 How often do you feel you are able to
a) Al of the time
have a say with the services that
b) Most of the time
provide support for you?
c) Some of the time
d) A little of the time
e) None of the time
7 Has the NDIS helped you be more
☐ Yes, a lot
involved?
☐ Yes, a bit
☐ No, not at al
☐ N/A (did not need help in this area)
Conclusion
Thank you for answering these questions. To close this out I just need to record (confirm)
who completed the questionnaire. You may also provide some comments if you wish.
Question
Answer options
1. Are you a participant in the NDIS or are you taking ☐ I am the participant
this questionnaire on someone else’s behalf?
☐ I am taking the survey on
someone else’s behalf
2. What is your relationship to the participant?
☐ Mother
☐ Father
☐ Spouse/partner
☐ Other family member
☐ Carer
☐ Friend
☐ Other (please specify):
3. Any comments?
13
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