At what point were you identified as a carer/family member/supporter when the person you support engaged with our services?

On Admission or Initial Appointment Within 1 month of Admission or Initial Appointment Within 6 months of Admission of Initial Appointment Other

If other, please confirm

Did you feel listened to and valued as a carer/family member/supporter?

Yes No

If you answered no, please provide further information

Did you feel you were involved with the treatment and informed of any changes about the person you support?

Yes No

If you answered no, please provide further information

Were you provided with support from the service and/or signposted to relevant support services in the Community?

Yes No

If you answered no, please provide further information

Please enter your postcode (if you do not have a fixed abode please type N/A)

What is your age group?

Under 18 18 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75+

To which of these ethnic groups would you say you belong?

Please type the first few letters... Asian or Asian British - Any other Asian background Asian or Asian British - Bangladeshi Asian or Asian British - Bangladeshi Asian or Asian British - Indian Asian or Asian British - Pakistani Black or Black British - African Black or Black British - Any other Black background Black or Black British - Caribbean Mixed - Any other mixed background Mixed - White and Asian Mixed - White and Black African Mixed - White and Black Caribbean Not known Not stated Other Ethnic Groups - Any other ethnic group Other Ethnic Groups - Chinese White - Any other background White - British White - Irish White

To which gender identity do you most identify?

Female Male Transgender Female Transgender Male Intersex Non-Binary Gender-fluid Gender-neutral Agender Pangender Gender Queer Prefer not to say

What is your sexual orientation?

Heterosexual or Straight Gay Lesbian Bisexual Asexual Queer Don't know Prefer not to say

Do you consider yourself to have a disability?

Yes No

If you answered yes, please indicate your disability (you can select more than one option)

Vision (e.g. due to blindness or partial sight) Hearing (e.g. due to deafness or partial hearing) Mobility (e.g. such as a physical impairment, difficulty walking short distances, climbing stairs, lifting and carrying objects, needing an aid) Learning or concentrating or remembering Mental Health Stamina or breathing difficulties Social or behavioural issues (e.g. due to neurodiverse conditions such as Autism, Attention Deficit Disorder or Asperger's Syndrome) Chronic Fatigue Chronic Pain Prefer not to say