Citizens Advice Cornwall is carrying out a survey into hidden homelessness in the county.

Please can you help us by sparing five minutes to complete this form, whether you consider yourself to be in a state of hidden homelessness or not? Please leave blank any questions that don't apply to your situation.

The survey is entirely confidential and will help us collect statistics to influence policymakers in Cornwall regarding the provision of affordable homes.

Many thanks, Citizens Advice Cornwall

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* 1. What is your age?

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* 2. Who do you live with?

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* 3. Do you have your own bedroom?

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* 4. Do you have any children under 18 living with you?

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* 5. Is where you live now a satisfactory situation for you?

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* 6. What sort of problems is it creating?

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* 7. Is where you live making it difficult to get to work or apply for the jobs you want to do?

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* 8. Reasons for leaving last home?

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* 9. Where are you living?

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* 10. Where do you see yourself living in 12 months' time?

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* 11. Where do you see yourself living in five years' time?

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* 12. Have you tried to seek housing support from your local authority?

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* 13. Are you on a housing waiting list?

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* 14. What do you feel authorities could do to improve the situation?
eg. affordable housing, hidden homeless census, converting empty shops to homes etc

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