A New Act to Replace the Disability Services Act (1986) – Video/audio submission A New Act to Replace the Disability Services Act (1986) - Video/Audio submission Step 1 of 9 11% If you would like to make a video or audio response to our consultation, this form will ask for your email address so that we can send you instructions. By providing a submission you consent to the department collecting and using your responses in accordance with the privacy notice.I have read and agree with the privacy notice and consent to participate in this consultation Yes We will first ask you some general questions about you and/or your organisation. What state or territory do you live in? Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia Outside Australia Is the region you live in: City area Regional area Rural/remote area Prefer not to say Do you identify as Aboriginal and/or Torres Strait Islander? Yes No Prefer not to say Do you identify as Culturally or Linguistically Diverse (CALD)? Yes No Prefer not to say Are you responding as an individual or on behalf of an organisation? Individual Organisation What is the name of your organisation? What are best describes where you provide services?(You can pick more than one option) City Regional area Rural/remote area N/A What best describes you?(You can pick more than one option) A person living with disability A carer, family member or friend of a person with disability A disability service provider A disability employment provider Disability peak body A disability advocacy provider Work for a disability organisation A mainstream provider Other Please specify My submission is in: * Required Video format Audio format Other Select all that applyPlease specify the format your submission will be in: Is there any other information you would like to give us regarding your submission?Your email address * Required Your email address will be used to send you instructions on supplying your submissionNameThis field is for validation purposes and should be left unchanged.