We want to ask you about how caring affects your relationships and social connections with other people. The survey takes about five minutes.

Please note that this survey is for people caring for a friend, relative or neighbour in Croydon who needs support due to illness, disability or old age.

We will use your responses anonymously to create a report, helping us raise awareness of carer loneliness and support our work.

It can be difficult to think about this topic. If you would like to talk to someone, please contact us. You can also call Samaritans for free listening support on 116 123. They are available 24 hours a day, seven days a week.

Please note that the Carers Information Service is committed to the confidentiality of your personal information. Personal data will be held and used in accordance with the Data Protection Act 1998 and will not be shared with any third parties for commercial use.

* 1. Are you happy to complete the survey and for your response to be included anonymously in our report?

* 2. I am an unpaid carer living or caring for someone in Croydon.

* 3. My caring role stops me from socialising with others as much as I want to.

* 4. I feel lonely or isolated because of my caring role.

* 5. What would help you feel less lonely or isolated in your caring role?

* 6. Please write any further comments on the impact caring has or has had on your relationships with others.

* 7. Has the Carers Support Centre helped you feel less lonely and/or isolated?

* 8. If yes, which Carers Support Centre services have helped you feel more connected with other people?

* 9. If you have any further comments on the difference the Carers Support Centre has made to your life and your relationships with others, please write them here.