Emergency Aware Baseline Survey

1. Please tell us the name of your suburb. *This question is required.

• Bulleen
• Doncaster
• Doncaster East
• Doncaster Hill
• Donvale
• Lower Templestowe
• Park Orchards
• Templestowe
• Warrandyte
• Wonga Park
• Other Please enter an 'other' value for this selection.

2. Do you live in either a fire or flood prone area? *This question is required.

• Yes
• No
• Don't know / unsure

3. How regularly do you prepare your property for either fire, storm, or flood events?

• Not at all
• Every year
• Twice a year
• Only if required
• Other Please enter an 'other' value for this selection.

4. Do you have an emergency plan? *This question is required.

• Yes
• No

5. Who would you discuss your emergency plan with? Tick all that apply.

• Family
• Friends
• Neighbours
• Community group / church
• Don't know / not applicable
• Other Please enter an 'other' value for this selection.

6. If a bushfire was near your home, would you leave early or stay and defend your property?

• Leave early
• Stay and defend my home
• Make a decision on the day
• Don't know / not applicable

7. If you had to leave your home at short notice in an emergency; where would you go?

• Family
• Friends
• Holiday house
• Hotel / Short term accommodation
• Emergency Relief Centre
• Don't know
• Other - please specify: Please enter an 'other' value for this selection.

8. How ready are you for an emergency in your area? Please tick one button in each row.

Space Cell	Yes definitely	No	Partially	Don't know / not applicable
I would enact my emergency plan BEFORE receiving an official warning for my home / suburb.	I would enact my emergency plan BEFORE receiving an official warning for my home / suburb.: Yes definitely	I would enact my emergency plan BEFORE receiving an official warning for my home / suburb.: No	I would enact my emergency plan BEFORE receiving an official warning for my home / suburb.: Partially	I would enact my emergency plan BEFORE receiving an official warning for my home / suburb.: Don't know / not applicable
I know where to find information about emergency warnings and emergency events.	I know where to find information about emergency warnings and emergency events.: Yes definitely	I know where to find information about emergency warnings and emergency events.: No	I know where to find information about emergency warnings and emergency events.: Partially	I know where to find information about emergency warnings and emergency events.: Don't know / not applicable
I have an emergency evacuation kit that includes first aid material, medications, copies of important documents and enough supplies for at least 72 hours AND it is easily accessible if I have leave home in a hurry.	I have an emergency evacuation kit that includes first aid material, medications, copies of important documents and enough supplies for at least 72 hours AND it is easily accessible if I have leave home in a hurry.: Yes definitely	I have an emergency evacuation kit that includes first aid material, medications, copies of important documents and enough supplies for at least 72 hours AND it is easily accessible if I have leave home in a hurry.: No	I have an emergency evacuation kit that includes first aid material, medications, copies of important documents and enough supplies for at least 72 hours AND it is easily accessible if I have leave home in a hurry.: Partially	I have an emergency evacuation kit that includes first aid material, medications, copies of important documents and enough supplies for at least 72 hours AND it is easily accessible if I have leave home in a hurry.: Don't know / not applicable
I know which roads are likely to be closed during a major emergency event.	I know which roads are likely to be closed during a major emergency event.: Yes definitely	I know which roads are likely to be closed during a major emergency event.: No	I know which roads are likely to be closed during a major emergency event.: Partially	I know which roads are likely to be closed during a major emergency event.: Don't know / not applicable
I have a plan for my pets and/or livestock during an emergency.	I have a plan for my pets and/or livestock during an emergency.: Yes definitely	I have a plan for my pets and/or livestock during an emergency.: No	I have a plan for my pets and/or livestock during an emergency.: Partially	I have a plan for my pets and/or livestock during an emergency.: Don't know / not applicable
My insurance adequately covers flood, storm, fire, bushfire and other natural disasters.	My insurance adequately covers flood, storm, fire, bushfire and other natural disasters.: Yes definitely	My insurance adequately covers flood, storm, fire, bushfire and other natural disasters.: No	My insurance adequately covers flood, storm, fire, bushfire and other natural disasters.: Partially	My insurance adequately covers flood, storm, fire, bushfire and other natural disasters.: Don't know / not applicable
I believe that emergency services would attend my residence to assist me during a widespread emergency event such as flood or bushfire.	I believe that emergency services would attend my residence to assist me during a widespread emergency event such as flood or bushfire. : Yes definitely	I believe that emergency services would attend my residence to assist me during a widespread emergency event such as flood or bushfire. : No	I believe that emergency services would attend my residence to assist me during a widespread emergency event such as flood or bushfire. : Partially	I believe that emergency services would attend my residence to assist me during a widespread emergency event such as flood or bushfire. : Don't know / not applicable
I understand that I am responsible for my safety during an emergency.	I understand that I am responsible for my safety during an emergency.: Yes definitely	I understand that I am responsible for my safety during an emergency.: No	I understand that I am responsible for my safety during an emergency.: Partially	I understand that I am responsible for my safety during an emergency.: Don't know / not applicable

9. Please let us know about you, your family and your neighbours.

Space Cell	Yes	No	Don't know
There is someone in my house who requires medication or care.	There is someone in my house who requires medication or care.: Yes	There is someone in my house who requires medication or care.: No	There is someone in my house who requires medication or care.: Don't know
I live alone.	I live alone.: Yes	I live alone.: No	I live alone.: Don't know
I own the property that I live in (or have a mortgage; not a renter).	I own the property that I live in (or have a mortgage; not a renter).: Yes	I own the property that I live in (or have a mortgage; not a renter).: No	I own the property that I live in (or have a mortgage; not a renter).: Don't know
I talk regularly to, and/or socialise with, my neighbours	I talk regularly to, and/or socialise with, my neighbours: Yes	I talk regularly to, and/or socialise with, my neighbours: No	I talk regularly to, and/or socialise with, my neighbours: Don't know
I am a member of a community group / sporting organisation.	I am a member of a community group / sporting organisation.: Yes	I am a member of a community group / sporting organisation.: No	I am a member of a community group / sporting organisation.: Don't know
I have shared my emergency plans with my family, friends and neighbours.	I have shared my emergency plans with my family, friends and neighbours.: Yes	I have shared my emergency plans with my family, friends and neighbours.: No	I have shared my emergency plans with my family, friends and neighbours.: Don't know
There is someone living alone in my neighbourhood who may need help during a heatwave or emergency event.	There is someone living alone in my neighbourhood who may need help during a heatwave or emergency event. : Yes	There is someone living alone in my neighbourhood who may need help during a heatwave or emergency event. : No	There is someone living alone in my neighbourhood who may need help during a heatwave or emergency event. : Don't know