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CARERS QUALITY QUESTIONNAIRE ADULT

CARERS
Name (optional)
Contact telephone number
Age range:

18-45

46-65

65+

Disability group of the person you care for:


_____________________

Other

Learning disabilities
disability

A child with

Physical disabilities

Mental Health
Sensory Services
Alzheimers/Dementia
Older people/frailty

Substance misuse

Autism/ADHD

Please tell us about the services you have used within the last
twelve months
Adult Carers: registration, information and support
one support
Befriending Service
Advocacy

One to

Young Carers Project

Parent Carers meetings

Male Carers group

Carer Forums

Coffee Morning
Bowling

Craft sessions

Ten Pin

Caring with Confidence/


(Pilates)
Carers Training

Carer events/

Fitness

outings

Please rate your opinion of the range of events and services on


offer:
Excellent

Good

Poor

How has being involved with CAST helped


you?...................................................................
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Carer Questionnaire Nov 2014

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Are there any other ways we can help you?
......................................................................................................................
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We understand that Carers can be inundated with forms but would like to
stress that the information you provide will be put to good use and could help
to protect the services we offer.
Thank you for your support, please return this questionnaire to:
Adult Carers Project, CAST, 1 Beach Rd, South Shields, Tyne & Wear, NE33 2QA

Carer Questionnaire Nov 2014

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