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look after your health and well-being improve your quality of life recognise your contribution as a carer increase your choice and control protect you from discrimination and harassment ensure you are treated with dignity and respect
But to do this well we would like you to help us understand what you need. Please can you answer the following questions for us so that we can provide the services to meet your needs? Every Questionnaire returned to Mencap@harrowmencap.org.uk will be entered into a prize draw for 50 Gift voucher return by Friday 21st September
Carers questionnaire
Not important at all Slightly important Very important
1 2
Which of the following ways would you like your GP to support you: priority appointments for you priority appointments for the person you care for annual health checks for you a practice support group YES
YES
NO
Which of the following would be useful to support you in your role as a carer? Carers break vouchers/respite support
NO
A service that provides you with a professional support worker to take over your role for a few hours Day trips and social events
Training and coaching support from a skilled professional to help you in your carers role.
Would you like the opportunity to help to shape the future carers services?*
*If you answer yes to this question please leave your details below so that we can contact you
Name _________________________________contact phone number _______________________ Email ____________________________________________________________________________