Please rate the below and provide any additional information that you want noted.

Rate each on a scale of 1 to 10, with one being very poor and 10 being very good

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* 1. The ease of getting the information you need as a Carer

N/A

Please provide any further comments you wish to make

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* 2. The support offered/experienced via the Carers' Support Service at 1 Town Hall Square, Grimsby.

N/A

Please provide any further comments you wish to make

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* 3. The support offered/experienced via any other carers service: (carers alert card, carers summer scheme, Care Plus Group, NAVIGO, Alzheimer’s Society)

N/A

Please provide any further comments you wish to make

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* 4. The support offered/experienced via a health or social care carers breaks service: (carers respite, carers sitting service, direct payment)

N/A

Please provide any further comments you wish to make

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* 5. The support offered/experienced from your social worker/ assessor in focus/NAViGO:

N/A

Please provide any further comments you wish to make:

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* 6. The support offered/experienced via the Single Point of Access (SPA) or the Family Information Service (whichever you have used – if you have used neither, choose Not Applicable)

N/A

Please provide any further comments you wish to make

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* 7. Your GPs identification and recognition of your caring role:

N/A

Please provide any further comments you wish to make:

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* 8. The hospital’s identification and recognition of your caring role:

N/A

Please provide any further comments you wish to make:

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* 9. If you haven't already said in the comments above, Please tell us what you would like to see happen in North East Lincolnshire to help support you as a carer.

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* 10. I am a: (select the option that is most appropriate for you)

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* 11. Please select your age range

Under 18

18-24

25-34

35-49

50-64

65-79

80+

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* 12. Please provide your postcode or the name of the ward you live in if you know it.

The following questions are all optional. We are asking them because the answers will help assess the impact of any changes that are made as a result of the consultation on different communities in North East Lincolnshire. Some questions may not be applicable to you, please leave them blank.

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* 13. Please select your gender

Man

Woman

Non-binary

Please let us know if you identify differently to the options given

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* 14. Is your gender the same as the sex you were given at birth?

Yes

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* 15. Have you gone through any part of the process of changing from your birth sex to the gender you identify as?

Yes

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* 16. What is your sexual orientation?

Lesbian

Gay

Bisexual

Heterosexual or straight

None of the above, please specify

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* 17. What is your relationship status?

Single

Married

Civil partnership

In a relationship (living together)

In a relationship (not living together)

Widowed

Divorced

Please let us know your relationship status if it is not described by any of the above.

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* 18. Do you consider yourself to have a disability? (please select the most appropriate)

If you feel that none of the above is appropriate, please let us know in your own words.

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* 19. What is your ethnicity?

Please use your own words if non of the above describe your ethnicity

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* 20. What is your religion or belief?

Christian

Muslim

Buddhist

Sikh

Jewish

Hindu

No Religion

Let us know your religion or belief if it is not listed above.

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* 21. Do you have any experiences where your interaction with our services have been positively or negatively affected because of your protected characteristics.

Yes

If your able to do so, please share details of your experience

THANK YOU for the time you have taken to complete this survey. Once the consultation closes, a draft Carers Strategy will be made available for Carers to provide further comments on. Your involvement means that the North East Lincolnshire Carers Strategy will focus on the things that Carer say are important, which is vital if the strategy is to help make things better for Carers in our area.