SW9 COVID-19 Survey

SW9 is conducting a survey of residents to try and identify those who need our support during the Coronavirus outbreak. Please do take two minutes to complete this as it could help you – or others – get much needed help during this period.

Any data you provide in this survey (that we do not already hold on our systems) will be kept for a maximum period of 6 months after the end of the COVID-19 pandemic. For more details please see our Privacy Statement here

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* 1. Do you believe you are vulnurable?

Yes

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* 2. Do you, or a member of your household, suffer from a medical condition that places you particularly at risk?

Yes

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* 3. Have you received a letter from NHS England advising you to self-isolate for 12 weeks due to a medical condition?

Yes

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* 4. Do you require support with any of the following:

Picking up shopping

Advice about paying your rent

Advice about paying for bills, food and other things

Picking up urgent supplies

Picking up medication

Meals

Contact (e.g. friendly phone call)

None of the above

Other (please state)

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* 5. Do you know of any other local residents who may need extra support but may not be able to complete this survey themselves?

Yes

If yes, please give details:

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* 6. Your details:

Name

Address

ZIP/Postal Code

Phone Number

Thank you for completing this survey. If there is anything you would like to talk to us about or need help with, please contact a member of staff on 0207 326 3700 or email info@sw9.org.uk