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* 1. Have you used The Birchall Trust service?

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* 2. Has one of your family members used The Birchall Trust service?

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* 3. Are you thinking about using our service? (for yourself or a family member)

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* 4. Do you know how to contact us?

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* 5. Did you know we have a website at www.birchalltrust.org .uk ?

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* 6. If you are thinking about using our service, but haven't contacted us yet, what are the barriers that are stopping you contacting us? Tick as many as apply to you;

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* 7. We want our service to be the best it can be. Would you like to help us shape our service?

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* 8. We would like you to help us work out how we deliver the best service we can. Which way would you prefer to help us shape our service?

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* 9. Would you like us to contact you for further information or to be involved in helping shape our service? Please leave your email address/phone number or address below;

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* 10. Thank you very much for completing this survey. Please tell us anything else you think we need to know.

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