Welcome to the Age-Friendly Survey for South Tyneside

The Age-Friendly Programme wants to improve the quality of life for older people in South Tyneside. This survey will help us understand the issues older people face
 
All answers are confidential and individual responses will not be shared.
 
You can return your completed survey to either address on the last page. Please return your survey by 1st December 2022
 
Thank you for taking the time to complete the form.
 
Section 1
About You
 
It is important that we understand the issues faced by older people of different age groups and living in different areas of South Tyneside. Please answer the following questions about yourself. If you don’t want to answer any of the questions, please leave it out.

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* 1. Are you

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* 2. Do you?

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* 3. Which of these groups includes your age?

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* 4. Are you:

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* 5. Are you:

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* 6. Which race/ ethnicity best describes you? (Please choose only one)

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* 7. Do you have a disability and/ or impairment?

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* 8. If ‘yes’ to question 7, which of the following does your disability and/ or impairment affect (Please tick all that apply)

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* 9. How is your health in general?

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* 10. How would you rate your quality of life?

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* 11. So that we can connect your answers with the area you live in, please include the first part of your postcode:

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* 12. Are you

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* 13. Do you live

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* 14. Is your home

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* 15. Do you receive any care at home?

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