ASK IF 0 = 1-8 (I.E. HAVE HEARD OF NEGATIVE CONSEQUENCES)
How did you hear about this negative consequence? Please select all that apply.
MULTIPLE RESPONSE, RANDOMISE
It happened to you...........................................................................................................1
It happened to a family member...............................................................................2
It happened to a friend / someone in your community...................................3
Heard / saw in the media............................................................................................ 4
Other (please specify)...................................................................................................5
Not sure / can’t remember..........................................................................................6
Exclusive
ASK ‘PRINCIPALS’
Do you believe any of the following is true of your appointed decision-maker(s)? They…
MULTIPLE RESPONSE, RANDOMISE
Are experiencing financial stress................................................................................1
Are your primary carer..................................................................................................2
Have an alcohol, drug or gambling addiction......................................................3
Are dependent on you financially............................................................................ 4
Are dependent on you emotionally.........................................................................5
Have experienced trauma............................................................................................6
Are experiencing personal or family difficulties..................................................7
None of these....................................................................................................................8
Exclusive
ASK THOSE WHO SELECTED ANY OPTION AT 0 OTHER THAN ‘NONE’
Do you think these circumstances pose any risk to you or your appointed decision-maker’s ability to
perform their role?
SINGLE RESPONSE
Yes – high risk....................................................................................................................1
Yes – medium risk............................................................................................................2
Yes – low risk.....................................................................................................................3
No risk................................................................................................................................. 4
Not sure...............................................................................................................................5
Chapter : 9
Appendices
83