Young Adult Carer Questionnaire Question Title * 1. How old are you? 14-15 16-17 18-20 21-25 Other (please specify) Question Title * 2. What is your gender? Female Male Other (please specify) Question Title * 3. What is your ethnicity? White (Welsh/English/Scottish/Northern Irish/British) Mixed/Multiple ethnic groups (White and Black Caribbean,White and Black African, White and Asian) Asian/Asian British (Indian, Pakistani, Bangladeshi, Chinese) Other (please specify) Question Title * 4. What is your sexual orientation? Hetrosexual or Straight Gay Lesbian Bisexual Other (please specify) Question Title * 5. What is your current religion, if any? Christian/Protestant/Methodist/Lutheran/Baptist Catholic Mormon Greek or Russian Orthodox Jewish Muslim Buddhist Hindu Atheist or agnostic Nothing in particular Other Question Title * 6. Please indicate which of the following services you have accessed with the YAC project. (Please choose all that apply) 1:1 support from your keyworker Youth club at Dr M'z Health and wellbeing workshops Activities/ Events/ Day Trips Grants Referrals to other agencies Other (please specify) Question Title * 7. If you have attended any events, workshops or youth clubs, please can you choose in which way they have helped from the following. (Please choose all that apply) Increased Self Confidence Increased Self Esteem Feeling less isolated Meeting new friends Learning new skills Other (please specify) Question Title * 8. On a scale of 1-10, where 1 is not at all and 10 is very much, how much has being with the YAC project helped you? 0 1 2 3 4 5 6 7 8 9 10 Please explain your answer. Question Title * 9. What do you like most about the YAC project and why? Question Title * 10. What do you least like about the YAC project and why? Question Title * 11. What other services would you like from the YAC project? Days Out Support Groups Other (please specify) Question Title * 12. Do you have any other comments, questions, or concerns? Done
