Retirement Village Survey

How would you identify yourself for this survey?Retirement village residentRetirement village ownerRetirement village staff

Retirement Village

Please tell us about your retirement village

What is the name of this retirement village? *

Is this retirement village part of a company? *YesNoNot Sure

What is the company name? *

How many Retirement Villages does the company have?

Please provide the village names and locations

What is the street address of this village?

Suburb/City *

State *

Postcode *Please check the postcode is correct —0 / 4

What is the website for the retirement village or company?

Live-in Pets

Please tell us about pets living in your facility

Does this retirement village or company permit residents to keep their own pet? *YesNo

If not, why?

Number of Birds kept by Residents

Number of Cats kept by Residents

Number of Dogs kept by Residents

Number of Other Species kept by Residents

Does this retirement village have a written policy on live-in pets? *YesNo

Does this retirement village have rules or regulations for live-in pets? *YesNo

What are those regulations?All dogs must be on a lead when it is outside your propertyAll cats must be kept insideYou may not acquire a new pet cat/dogOther:Please select all that apply, these are just examples of common rules

Other RulesPlease enter any other rules you are aware of

Does your village have regular vets or groomers visit? *YesNo

The CANA Pet Friendly Kit

Our kit has been developed and endorsed by CANA, ACIPC (Australasian College for Infection Prevention Control) and AVA (Australian Veterinary Association). It contains everything from policies to support material.

Have you received our new Pet Friendly kit for your village/company? *YesNo

Great! We would love to know what you think of itAll feedback is appreciated

Would you like to receive our new Pet Friendly kit for your village/company? *YesNo

Postal details required

Please ensure the name of your Facility above and your postal, email and phone details are provided below. Thank you!

Would you like to have staff training video on pets included in your orientation if it was available? *YesNo

Your Responses

Can we contact you if we wish to discuss aspects of your responses? *YesNo

Name *

Title/Role

Email Address *

PhoneA phone number is optional but appreciated

Postal Address

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