1. I am a: (You can select more than one if more than one option is relevant to you)
    2. Young Carer (I am under 18 years old and care for a family member)Young Adult Carer (I am 18 to 25 years old and care for a family member or friend)Parent Carer (I care for a child under the age of 18 who has additional needs)Adult Carer (I am over 25 and care for a family member or friend who is over 18 years old)

    3. I will recommend The Carers' Support Service to a family member or friend
    4. Strongly AgreeAgreeDisagreeStrongly Disagree

    5. Overall I am satisfied with the Carers' Support Service
    6. Strongly AgreeAgreeDisagreeStrongly Disagree

    7. The Carers' Support Service gave me the help I needed
    8. Strongly AgreeAgreeDisagreeStrongly Disagree

    9. I will definitely use The Carers' Support Service again
    10. Strongly AgreeAgreeDisagreeStrongly Disagree

    11. When contacting The Carers' Support Service, I found the person I spoke to friendly
    12. Strongly AgreeAgreeDisagreeStrongly Disagree

    13. Please let us know what services you have accessed from The Carers' Support Service. You can select more than one option
    14. General Information and AdviceCounsellingBefriendingBenefits AdviceCarer Peer Support GroupsActivities & TrainingMassage / Holistic Therapies

    15. Please give us some feedback about the services/support you have accessed. Please let us know if you found them useful and if there is anything we can improve on
    16. We provide support based on what Carers tell us they want. There is also other local support available for Carers, but at times you may feel as though the support you need just isn't available. Please let us know if you think there are any gaps in support for Carers.
    17. Do you have any other comments, questions, or concerns?
    18. Please give us your contact information if you would like us to contact you about any of your comments, otherwise you may leave this section blank.
    19. Name
      Address
      Address 2
      Town
      Post Code
      Email Address
      Phone Number