Survey for local business
The (insert council) is concerned about the consumption of alcohol products in our community. Alcohol fuels violence and chronic diseases, and causes significant harm to individuals, families and communities. We know you want our community to be a healthy and safe place to live and work. As a local business, we would like to hear your thoughts on this issue.
This short survey covers a range of issues and responsibilities for both the (insert local council) and businesses. By gathering people’s responses to this survey we will [insert action here and how you will provide feedback to participating businesses]
The (insert council) includes the suburbs of (list).
If you would like to discuss this project with the (insert local government), you can contact (insert contact).
This survey will remain open until (insert date).
If you are interested in the results of the survey please sign up here: (insert link to sign-up for feedback on results)
Q1. Have you or your employees experienced any problems or harms from alcohol products in or near your licensed premises? If yes, please indicate the effects below:
- Loss of customers
- Noise
- Property damage
- A feeling of being unsafe
- Customers being unsafe
- Antisocial behaviour near or on the premises
- Violence
- Litter
- Physical or verbal fights
- We have not been affected
- Other – please list:
________________________________________________________________
Q2. Do these issues occur (please tick the option that best fits your circumstances):
- Daily
- Weekends
- On a weekly basis
- Once a fortnight
- Rarely
- Never
- Other – please describe:
________________________________________________________________
Q3. Would any of the following strategies be useful in or around your premises?
- Increased security patrols
- CCTV
- Better lighting
- Education for the public on low-risk drinking
- Other – please specify:
________________________________________________________________
Q4. If you nominated any of the above strategies, why do you think they are needed?
________________________________________________________________
Q5. On a scale of 1 to 5 with 1 being ineffective and 5 being very effective, please rank how effective you think the following strategies would be in reducing harm from alcohol products within the (insert council).
- Limits on new high-risk liquor outlets (insert number)
- Increased security patrols (insert number)
- Limits on alcohol advertising within 400m of schools (insert number)
- Better lighting (insert number)
- Community forum on alcohol to discuss (insert topic). (insert number)
- CCTV (insert number)
- Annual local licensee forum to discuss harms from alcohol products and local solutions (insert number)
- Offering more alcohol-free activities and spaces for young people to socialise without alcohol products (insert number)
Do you have any other suggestions?
________________________________________________________________
Q6. If the (insert council) could do one thing to support your business to prevent the harms from alcohol products, what do you think that should be?
________________________________________________________________
Q7. What is your age? (please circle)
- 18 to 24
- 25 to 34
- 35 to 44
- 45 to 54
- 55 to 64
- 65 to 74
- 75 or older
Q8. What is your gender?
________________________________________________________________
Q9. Please identify the type of business you operate (general terms are fine e.g. small bar, bottle shop)
________________________________________________________________
Q10. What is your postcode for your premises?
________________________________________________________________
Thank you for your time
This tool was developed with the support, expertise and guidance of Dr Melissa Stoneham.
