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  2. 2015
  3. April
  4. H
  5. Healthwatch Hackney
0%
Exit Survey
 
 
Interviewer's initials
   
 
 
 
Venu
   
 
 
 
Gender
 
Male
 
Female
 
 
 
Age
 
18-24
 
25-30
 
31-40
 
41-50
 
51-60
 
60+
 
 
 
Level of English
 
Fluent
 
Good
 
Poor
 
None
 
 
 
Disability?
 
Yes
 
No
 
 
 
Has this ever been a barrier to you understanding or accessing this service?
 
Yes
 
No
 
 
 
Are you a family carer?
 
Yes
 
No
 
 
 
Ethnic Categories: White
 
British
 
English
 
Welsh
 
Irish
 
Greek / Greek Cypriot
 
 
 
Ethnic Categories: Mixed
 
White and Black Caribbean
 
White and Black African
 
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