1. Equipment Survey

- Things I use

- Other help I get

- Overall, how much difficulty? (1-5)

- Costs aside, what aids and equipment improvement or solution would best meet your needs? (devices, environments, support)

- What could you do as a result of these changes that you can’t do now?

  • What impact on your time would these changes have?

2. AQOL

3. Demographic Questions

Repeat survey questions for each domain:

  • Personal wellbeing

  • Social life

  • Political life

  • Cultural life

  • Recreational and leisure life

  • Economic life

  • Educational life

  • Spiritual life

pie chart to symbolise domains of life