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We are always looking at ways to improve and do things better so if you could spare five minutes to tell us what you thought of our service we would very much appreciate your feedback.
 
It is important for us to check we are reaching all sections of the Northumberland community as everyone has a different experience depending on age, sex, disability etc. so if you could also tell us a little about yourself or, if you have contacted us on behalf of someone else such as a child or relative, a little bit about them.

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* 1. What date was your recent enquiry with Healthwatch Northumberland?

Date

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* 2. How did you first make contact with us?

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* 3. Which area of health or social care did you make contact with us about?

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* 4. How satisfied were you with your contact with Healthwatch Northumberland

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* 5. How likely is it that you would recommend us to your family, friends or colleagues

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* 6. Where did you hear about Healthwatch Northumberland?

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* 7. What age bracket are you, or the person you are telling us about?

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* 8. What is your sex, or the sex of the person you are telling us about? (a question about gender identity follows)

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* 9. Is your, or the person you are telling us about's, gender identity the same as your sex registered at birth?

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* 10. What is your sexual orientation or the person you are telling us about?

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* 11. What is your ethnicity, or the person you are telling us about?

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* 12. What is your religion or belief, or the person you are telling us about?

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* 13. What is the marital or civil partnership status of you or the person you are telling us about?

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* 14. What is your pregnancy or maternity status or of the person you are telling us about?

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* 15. Do you, or the person you are telling us about, have a disability?

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* 16. Do you, or the person you are telling us about, have a long-term health condition?

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* 17. Are you, or the person you are telling us about, a carer?

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* 18. Do you have any further comments you would like to make about your contact with us including anything we could do to improve

Thank you for your time in completing this.
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