Community Activities Feedback
We are developing more community‑based activities for people living with early‑stage dementia, and would love to learn what kinds of groups or activities would be most meaningful or enjoyable for you. You can fill this out for yourself or on behalf of the person you support.
What is your name?
Where do you live? (e.g., Waitara, Bell Block, Inglewood)
What activities would you enjoy? (Tick as many as you like)
Gentle movement or exercise
Walking group
Arts and crafts
Volunteering
Music or singing
Social morning tea
Games or puzzles
Gardening
Guest speakers or learning sessions
Outings in the community
Help with phones or technology
Other (please write below)
What days are most convenient for you?
Monday
Tuesday
Wednesday
Thursday
Friday
Do you prefer morning or afternoon activities?
Morning
Afternoon
Don't mind
Is it hard for you to get to activities if we do not provide transport?
Yes
No
Sometimes
I’m not sure
Is there anything else you would like to tell us? (ideas, needs, or worries)
Submit
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