You will note that we want information about your entire household; this information will help us to develop services for the future.
Please complete section 1 – Your Household details; using the following example:
| Person 1 | Mr | Joe | Jones | 18.11.1957 | M | Tenant |
| Person 2 | Mrs | Jane | Jones | 12.12.1961 | F | Joint tenant / Or partner |
| Person 3 | Mr | Davey | Jones | 09.02.1998 | M | Son |
| Person 4 | Miss | Diane | Jones | 15.5.2002 | F | Daughter |
As you go through the form you will then refer to each member of your family as they appear on section 1, i.e. Davey Jones will be Person 3 throughout the form.
Then as you go through the form you are asked to the relevant boxes on some questions. On other questions you are asked to give us a response in order of importance use 1 for the most important and higher numbers to indicate what is less important or something that is not an issue for you.
If you need help completing this survey call Deborah Floody on 01858414540 or Tracey Silk on 01858414519