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.1745-0720 Haemodialysis 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 Please choose... Full time Part Time Non working Retired Housewife/househusband In education Other: Other: (This question is mandatory) If applicable, what is your occupation? (This question is mandatory) Are your details currently registered with us? If you haven't, please do so here http://https://www.healthcareopinions.co.uk/ Choose one of the following answers Yes No (This question is mandatory) Where did you hear about this research participation opportunity? Check all that apply Email directly from Research Opinions Recommended from a friend or family member Healthcare Opinions website Facebook Instagram Other: (This question is mandatory) Do you, or someone you provide care for, currently receive, or have received haemodialysis treatment in the last 3 months? Choose one of the following answers Please choose... I currently receive haemodialysis treatment I currently provide care for a person who receives haemodialysis treatment None of these (This question is mandatory) For how long have you/ the person you care for been receiving haemodialysis? (This question is mandatory) For what condition do you/ the person you care for receive haemodialysis treatment? (This question is mandatory) If you are providing care for a person receiving haemodialysis treatment, please can you tell us how you are related to this person, and what type of care you provide to them? Submit Load unfinished survey Resume later Please confirm you want to clear your response? Exit and clear survey ×