Selby District Disability Survey Selby District Disability Forum CIC is a volunteer run local organisation which aims to raise awareness and address the needs of people with a disability.

We have secured funding to carry out a major consultation with residents across the District, working in partnership with Selby District AVS. The survey aims to capture a detailed picture of service needs among people with a disability. Your feedback will be used to develop a range of funding applications to address the issues you raise this autumn.

Please share your thoughts and ideas regardless of whether you have a disability yourself or not.

Our report and analysis of the data will be published on the Internet and we will share the findings with service providers across all sectors.

AVS staff will be happy to come and talk to any groups about completing the survey, sending out paper copies, large print versions, or taking down your opinions over the phone – please contact us on 01757 291111 or email us at reception@communityhouse.org.uk

Thank you for taking part.

Phil Dodson, Chair of Selby District Disability Forum

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* 1. Which part of Selby District do you live in? (please tick)

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* 2. How old are you?

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* 3. Are you? (please tick all that apply)

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* 4. If you are a person with a disability, how would you describe your disability? (please tick all that apply)

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* 5. Does your disability make you feel any of the following? (Please tick all that apply)

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* 6. How do you feel about where you live?

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* 7. How accessible do you find Selby District on a scale of 1 completely inaccessible to 5 completely accessible, across these different environments?

  1 2 3 4 5
At work / college / school
In social venues – restaurants / clubs / leisure centres / pubs
Out and about on roads / pavements / parks and open spaces
In public service buildings – council / GPs / hospital / police

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* 8. Have you ever experienced direct or indirect bullying, harassment, street harassment or attack because you have a disability or mental health issue?

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* 9. Have you ever experienced hate crime in Selby District? This could include a verbal insult, threat, physical or sexual assault, graffiti or damage to your property.

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* 10. Do you think it is important that we address the issues people with a disability face in our District?

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* 11. What would you like to see addressed? (Please tick all that apply)

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* 12. What impact would addressing the needs of people with disabilities have on you?

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* 13. Getting Involved (Please tick all that apply)

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* 14. If you have ticked any of the above please provide the following; your name, telephone number and email address

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