CVSC Integrated Health and Social Care Questionnaire

Application to join the CVSC Health and social care transformation group

CVSC will be collecting service user feedback to assist with the integration of health and social care services between Betsi Cadwaladr University Health board, Conwy County Borough Council and the third/voluntary sector. We are recruiting Individuals who live within Conwy County who have used these services, their families and carers as well as those working within the third sector. The initial group will be part of a co-production group to help design the questions and methods used.

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* 1. Are you willing to share your experiences about using these services? Any information you share will be anonymised.

Yes

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* 2. What is your name?

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* 3. At what email address would you like to be contacted?

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* 4. What is your current address.

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* 5. What is your age?

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

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* 6. What is your gender?

Male

Female

Other (please specify)

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* 7. Are you a person living with a disability?

Yes

Please give details of any additional support you may need to take part.

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* 8. Have you used services provided by BCUHB, CCBC or the third/voluntary sector?

Yes - BCUHB

Yes - CCBC

Yes - third sector (please include details in comment box)

Other (please specify)

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* 9. Not all applicants will be able to take part in the first group as we need a variety of voices from different parts of the community. We will have further opportunities to share your experiences at a later date. Can we contact you to take part in additional research?
Our privacy policy can be found at https://cvsc.org.uk/en/privacy-policy

Yes