Toggle navigation Load unfinished survey Resume later Exit and clear survey default Caution: JavaScript execution is disabled in your browser or for this website. You may not be able to answer all questions in this survey. Please, verify your browser parameters. H.1993-0821 Wellbeing Survey You are about to fill in a short survey which will help determine your suitability to this research project. Please be aware that all data you provide us with will be held in accordance with the data protection policy outlined on our website. For further information please visit https://www.healthcareopinions.co.uk/privacy-policy/ (This question is mandatory) What is your name, contact number and email address? First Name Surname Contact Number Email Address Postcode (This question is mandatory) Please tell us your age. Only numbers may be entered in this field. Your answer must be between 1 and 99 (This question is mandatory) Are you... Choose one of the following answers Male Female Prefer not to say Other: (This question is mandatory) What is your working status? Choose one of the following answers Full time Part Time Non working Retired Housewife/househusband In education Other: (This question is mandatory) If applicable, what is your occupation? (This question is mandatory) Do you have a vision impairment or difficulty seeing that is not corrected by glasses or contact lenses? Choose one of the following answers Yes No (This question is mandatory) Are you registered as partially sight impaired or severely sight impaired? Choose one of the following answers Registered severely sight impaired Registered partially sight impaired Registered but don’t know which category Not registered (This question is mandatory) How would you desrcibe your ethnicity? Submit Load unfinished survey Resume later Please confirm you want to clear your response? Exit and clear survey ×
