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Polyphonic

Day One Survey

As part of delivering this program through a grant from the Department of Social Services (DSS), we are required to ask a few short questions. Please complete the form below.


Let us know if you need any assistance completing this form.

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If this is the participant, enter your name again.


Participant Information

Are you an NDIS Participant?
Yes
No
Are you a Carer?
Yes
No
Main reason for participating in this program?
Improve Mental health, wellbeing and self-care
Engage in community events
Education and skills training

  1. Community Participation


  1. Mental Health


  1. Skills


  1. Independence


  1. Experience


  1. Support


Anything Else?

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