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* 1. Do you or someone you care for have any of the following? (please tick all that apply)

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* 2. What age bracket do YOU fit in?

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* 3. What age bracket does the person you care for fall in?  (if you care for more than one person, tick multiple boxes if appropriate)

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* 4. If you haven’t had a holiday for 2 years or more, was it because (& tick all that apply)

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* 5. Do you think a short holiday would have any of the following benefits (& tick all that apply)

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* 6. If you were able to have a short holiday in an adapted luxury caravan, at a reduced cost would you be interested?

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* 7. If no, using the comment box, can you share why you wouldn't be interested ?

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* 8. We are collecting information about how often caring families manage to take a holiday.  Would you be willing to give your views to help us offer free or heavily subsidised holidays?  (This could be via telephone, email or as part of a small  group)

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* 9. How would you like to be involved? (tick all that are suitable for you ) thank you

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