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* 1. Name

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* 2. Email

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* 3. Choose 3+ words to describe how your emotional and mental wellbeing has been impacted by the pandemic. Please add more words if you wish.

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* 4. Choose 3+ words to describe what you would like to get out of our artists wellbeing programme. Please add more words if you wish.

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* 5. Please tick what types of activity you would be interested in and add any extras below.

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* 6. Please outline what times of the week would best work for you (we will try to programme events to suit the majority of respondents)

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* 7. Please share any further ideas you have here

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