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Questions marked with a * are required Exit Survey
 
 
* How many children do you have? (Under 16's)
 
1-2
 
2-3
 
3-5
 
5+
 
 
 
How old are your children? (Select all that apply.)
 
0-1
 
1-3
 
3-5
 
5-9
 
9-11
 
11+

 
 
 
How many of the following illnesses have your children had (Select all that apply)?
 
chickenpox
 
common cold
 
croup
 
fever
 
measles
 
mumps
 
rubella
 
whooping cough

 
 
 
What types of over the counter medication have you heard about (Select all that apply)?
 
Calpol
 
Sambucol
 
mindlinks
 
Other

 
 
 
If your child was ill how would you entertain them(Select all that apply)?
 
films
 
games
 
encourage them to rest
 
take them out for a walk

 
 
 
* If your child has been diagnosed with croup, if and when would you got to A&E.
 
 
If they stay in the same condition
 
if they have a temperature of 39.4 (or higher)
 
if they are vomiting but are staying hydrated
 
if they are lethargic and loose there appetite
 
 
 
if your child is diagnosed with croup when would you call an ambulance
 
skin, fingertips or lips have a blue tinge
 
if they have a high temperature of 37.4
 
if they are coughing more than usual
 
 
 
* when you're children are ill in what ways do you keep your child occupied?