| Characteristics of Person (If Known) |
How Contact Made—Attempt 1 |
How Contact Made—Attempt 2 |
How Contact Made—Attempt 3 |
Outcome (Choose One Option)
|
| Gender: |
-
□
In person
-
□
Phone call
-
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Text message
-
□
Email
|
-
□
In person
-
□
Phone call
-
□
Text message
-
□
Email
-
□
N/A
|
-
□
In person
-
□
Phone call
-
□
Text message
-
□
Email
-
□
N/A
|
-
□
Ineligible
-
□
Survey completed
-
□
Took survey link for completion at a later date
-
□
No response
-
□
Refused—too busy
-
□
Refused—not interested
-
□
Refused—uncomfortable
-
□
Refused—incapable of completing (i.e., literacy, language)
-
□
Refused—reason not given
-
□
Refused—other
|
| Actual or estimated age: |
| Country of birth: |
| Length of time in Australia: |
| Gender: |
-
□
In person
-
□
Phone call
-
□
Text message
-
□
Email
|
-
□
In person
-
□
Phone call
-
□
Text message
-
□
Email
-
□
N/A
|
-
□
In person
-
□
Phone call
-
□
Text message
-
□
Email
-
□
N/A
|
-
□
Ineligible
-
□
Survey completed
-
□
Took survey link for completion at a later date
-
□
No response
-
□
Refused—too busy
-
□
Refused—not interested
-
□
Refused—uncomfortable
-
□
Refused—incapable of completing (i.e., literacy, language)
-
□
Refused—reason not given
-
□
Refused—other
|
| Actual or estimated age: |
| Country of birth: |
| Length of time in Australia: |