Carers Leeds service questionnaire 2018

Carers Leeds service questionnaire 2018

Ireland Wood carer clinic

Bat and Chat

Alzheimer’s carers support group

Alzheimer’s carers support group

Learning disability carers group

Carers Leeds service questionnaire 2018

To help us develop and improve our services we would like you to complete and
return this questionnaire. You can fill it in anonymously but if you would like to be
entered into a prize draw to win a £30 shopping voucher please add your contact
details at the end.

THANK YOU for taking the time to help us.

To help us develop and improve our services we would like you to complete and
return this questionnaire. You can fill it in anonymously but if you would like to be
entered into a prize draw to win a £30 shopping voucher please add your contact
details at the end.

THANK YOU for taking the time to help us.

To help us develop and improve our services we would like you to complete and return this questionnaire. You can fill it in anonymously but if you would like to be entered into a prize draw to win a £30 shopping voucher please add your contact details at the end.

THANK YOU for taking the time to help us.

To help us develop and improve our services we would like you to complete and
return this questionnaire. You can fill it in anonymously but if you would like to be
entered into a prize draw to win a £30 shopping voucher please add your contact
details at the end.

Please tell us about yourself:

Do you have any health problems? (tick all that apply)

Please tell us about which services you have used and what you think of them.

What kind of information or support has been most helpful to you? (tick all that apply)

Please tell us about yourself:

Do you have any health problems? (tick all that apply)

Please tell us about which services you have used and what you think of them.

What kind of information or support has been most helpful to you? (tick all that apply)

Please tell us about yourself:

Do you have any health problems? (tick all that apply)

Please tell us about which services you have used and what you think of them.

What kind of information or support has been most helpful to you? (tick all that apply)

Are you male or female?

How old are you?

How long have you been a carer?

How many people do you care for?

Are you currently in paid work?

Are you doing any voluntary work?

Stress / AnxietyLow Mood / DepressionDifficulty SleepingPhysical health problem e.g. COPD, diabetes

Have you had a meeting with a Carer Support Worker?

If yes, did you find it:

Have you had a drop-in meeting at Carers Leeds?

If yes, did you find it:

Have you had telephone support?

If yes, did you find it:

Have you visited a carer support group?

If yes, did you find it:

Have you had Training? (e.g. Dementia, Caring Well etc)

If yes, did you find it:

Have you made use of our befriending service?

If yes, did you find it:

Have you attended a carers event, trip or social activity?

If yes, did you find it:

Being able to talk about my caring situationMeeting other carersGetting help with welfare benefitsGetting a Carers AssessmentGetting information about other services

How could Carers Leeds be more helpful to you in your caring role?

This questionnaire submission page will close on the 31.07.18

Would you like to be entered into the Prize Draw to win a £30 shopping voucher

Name:
Telephone number:

« August 2018 »