NEC Care: Your screening appointment

We would like to find out some information about you.

The answers you give to this survey are completely anonymous. The data we collect is used to improve the service we provide to our patients. Questions marked with * are compulsory.

Question Title

* 1. Which Diabetic Eye Screening Programme (DESP) are you registered with?

Arden, Hereford & Worcester DESP

BaNES, Swindon & Wiltshire DESP

Central Mersey DESP

Dorset DESP

North of Tyne & Gateshead DESP

South West London DESP

Surrey DESP

West Ridings & Craven DESP

Republic of Ireland DRSS

Question Title

* 2. What is your ethnic group?

Question Title

* 3. Please indicate which age range you fit into

12-15

16-24

25-34

35-44

45-54

55-64

65-74

75-84

85+

Question Title

* 4. Are you

Male

Female

Not specified