Brimbank community advisors

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We want to help make Brimbank the most thriving, connected and healthy community it can be.

Do you live or work in the City of Brimbank? Have you or someone you know experienced wellbeing and/or mental health challenges?

If yes, you can fill in this form to express your interest in becoming a Brimbank community advisor. This form should take approximately 10 minutes to complete.  If you need help with this form, please contact Jo on  0439 649 788.

Your full name(Required)

Preferred form of communication(Required)

Phone call

Text message

Phone number(Required)

Email (optional)

We are considering different research and design activities for you to take part in. It will help us if you can let us know how you would like to participate.

Select your preferred method/s of participation

1 on 1 interview or chat about what matters to me

Focus group on specific issues (talking only)

Workshop on specific issues (talking and group activities)

Answering short surveys

Being part of a regular advisory group

Select the format that suits you best

Online activities

Phone call

In person

We're want to hear from people from different perspectives, backgrounds and lived experiences. This will help us design a space and offering that is truly inclusive.

Please tick all options that apply to you

I live with disability

I experience more than one health issue

I have lived/living experience of substance use or dependence

I am experiencing unstable housing or homelessness

I am engaged in the criminal justice system

I am engaging with employment services

I am a member of the LGBTQIA+ community

I am a refugee or asylum seeker

I have lived in Australia for less than 4 years

I am a single parent

All my family live overseas

What are your pronouns?

she/her

he/him

they/them

prefer not to say

Other

Age

25 or less

26 - 35

36 - 55

55 - 65

65 - 74

75 - 84

85 or older

What suburb do you live in?

We ask about your cultural background because we understand that different cultural backgrounds experience wellbeing differently, and for us it is important to understand wellbeing from different cultural and ethnic perspectives.

Are you Aboriginal and/or Torres Strait Islander?

Yes, Aboriginal

Yes, Torres Strait Islander

Yes, Aboriginal and Torres Strait Islander

What cultural background do you identify with?

Which is your current status in Australia?

We ask this because we understand that your current status might impact which services you get access to.

I am an Australian citizen

I am a permanent resident

I am a temporary visa holder

I am a visitor

Other

There are different factors that affect our wellbeing, including financial stability, connection to community, housing, environment and mental health. Here are some questions that will help us understand more about your current situation.

What is your current employment status?

Unemployed or unable to work

Casual/Job share

Part-time

Contract/temporary

Full-time

Business owner/sole trader

Prefer not to say

Have you experienced mental health or wellbeing challenges in the last two years (including depression and anxiety)?

Yes, and I am still experiencing them or some of them

Yes, and I am now doing well

I am not sure

Select any mental health services you have used in the past

Online or phone support

Self-help app

Peer support

Counselling support

Psychotherapy

Psychiatric treatment

Hospitalisation

Structured physical activities

Support group

None of these

Something else

Please tick all options that apply to you

I am not eligible for mental health services

I don't know if I am eligible for mental health services

I have not used a mental health service

I have contacted a mental health service

I am waitlisted for a mental health service

I have received support in the past but not currently

I have regular contact with a service to support my mental health

I am a parent/carer or have helped someone get help support person

Popular locations

Menu Services

Brimbank community advisors

Registration form

About us

Popular locations

Menu Services

Brimbank community advisors

Registration form

About us

Select a location and book online