Youth Health Stockton General Health Survey

Youth Health Stockton are gathering feedback about your general health and experiences of local health and social care services to identify if improvements are needed to these services. All feedback is anonymous.

Question Title

* 1. What is your gender?

Question Title

* 2. What is your age?

11 -13

14 - 15

16 - 18

19+

Question Title

* 3. What is the first half of your postcode? (E.g. TS18)

Question Title

* 4. Are you physically active?

Yes

If yes, what physical activity do you do?

Question Title

* 5. Do you consider yourself to have a healthy diet?

Yes

Comments:

Question Title

* 6. Do you regularly smoke tobacco?

Yes

Comments:

Question Title

* 7. Do you regularly use vapes / e-cigarettes?

Yes

Comments:

Question Title

* 8. Do you regularly consume alcohol?

Yes

Comments:

Question Title

* 9. Do you regularly use drugs / legal highs?

Yes

Comments:

Question Title

* 10. Do you have a healthy sleep pattern?

Yes

If no, please explain why?

Question Title

* 11. Do you consider yourself to have a mental health condition?

Yes

Please give details (optional)

Question Title

* 12. Have you been medically diagnosed with a mental health condition?

Yes

Comments:

Question Title

* 13. Have you self-diagnosed yourself with a mental health condition?

Yes

If yes, why did you choose to self-diagnose?

Question Title

* 14. Do you consider yourself to have a physical health condition?

Yes

Please give details (optional)

Question Title

* 15. Have you tried meditation or other holistic therapies?

Yes

If yes, what holistic therapies have you tried?

Question Title

* 16. Do feel comfortable taking un-prescribed medication? E.g. paracetamol

Yes

If no, please explain why?

Question Title

* 17. Do you feel comfortable taking prescribed medication e.g from your GP?

Yes

If no, please explain why?

Question Title

* 18. Are you concerned about your physical health?

Yes

Comments:

Question Title

* 19. Are you concerned about your mental health?

Yes

Comments:

Question Title

* 20. Are you concerned about your sexual health?

Yes

Comments:

Question Title

* 21. Are you comfortable speaking to an adult about your health concerns?

Yes

If no, please explain why?

Question Title

* 22. Who would you feel most comfortable to talk to about your health concerns?

Question Title

* 23. Do you feel as though you have been made fully aware of the health services available to you?

Yes

Comments:

Question Title

* 24. Have you accessed any health services within the last 3 months?

Yes

If yes, which services?

Question Title

* 25. Were there any barriers to accessing these health services?

Yes

If yes, what were the barriers?

Question Title

* 26. Have you experienced any barriers when accessing health services? e.g. waiting times

Yes

Please give details:

Question Title

* 27. Are you treated kindly and fairly by healthcare professionals?

Yes

Additional Comments:

Question Title

* 28. Are you happy with our current health services?

Yes

If no, please tell us what you think needs to be improved?

Question Title

* 29. KOOTH (www.kooth.com) is a a free, online counselling and emotional wellbeing support service for young people. Have you heard of Kooth?

Yes

Question Title

* 30. Have you every used KOOTH?

Yes

Question Title

* 31. If you answered 'yes' to question 30, how helpful did (do) you find the service provided?

Extremely helpful

Very helpful

Somewhat helpful

Not so helpful

Not at all helpful

Question Title

* 32. Do you have any other feedback you would like to share with us about your views and experiences of local health and social care services?

Question Title

* 33. Would you like to be involved with our Youth Health groups in the future? If yes, please leave your contact details below.

Name

Address

City/Town

Post Code

Email Address

Phone Number