Elmbridge health and wellbeing survey

1. Help us to improve health and wellbeing for you and your family

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North West Surrey Health and Care Alliance is a partnership comprising local health, social care, voluntary sector and Council professionals who have come together to help improve the health, wellbeing and life chances of local people.

It is essential that we hear from the local community in Elmbridge about their experience of life in this area to help us identify ways of achieving our goals.

The survey should take no longer than 10 minutes to complete and is anonymous. If you decide to give your contact details to stay in touch about future opportunities, these will not be linked to your results.

Alternatively, if you require a hard copy or a version in large print or another format such as braille or in a different language, please contact syheartlandsicb.nwsalliance.comms@nhs.net or call 07747 638540

For more information about how we keep your data private and confidential please visit:
https://www.surreyheartlands.org/how-we-use-your-information
 

1. What is the first half of your postcode? (for example...KT13) *

 

2. If you or a member of your household is feeling unwell, how would you access non-emergency healthcare? (select all that apply) *

 

3. If you use the internet to access non-emergency healthcare services, information or advice, which of the following are you likely to use? (select all that apply) *

 

4. Are you registered with a GP practice?

If option 2 (No) of this question was selected then jump to Q7 ( What is your main mode of transport ) *

 

5. Please select which one from the list below *

 

6. How easy do you find it to access your GP/GP surgery's services? (1 = very inaccessible, 10 = completely accessible) *

 

7. What is your main mode of transport *

 

8. When thinking about health and wellbeing, what do you feel to be priority areas for you and your family? 1 is the lowest priority, 5 is the highest priority. Please outline any concerns in the comments box below.

Select the most applicable option in each row. *

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Enough money
Regular exercise/leisure pursuits
Nutritious diet
Access to the outdoors/green spaces
Enough sleep
Healthy self-esteem
Feeling part of a community
Happy relationships
 

9. Do you think you get enough exercise (NHS guidance is 150 minutes of moderate activity or 75 minutes of vigorous activity each week) *

 

10. Do you worry about any of the following in relation to your home? Select all that apply *

 

11. How safe do you feel in your home and local area? (1 = very unsafe, 10 = completely safe) *

 

12. Overall, how would you rate your mental health and wellbeing during the past month? (1=very poor, 10=excellent)

If you or someone you know needs mental health support please visit https://www.healthysurrey.org.uk/mental-wellbeing for information and help. *

 

13. What types of communications access do you have? (select all that apply) *

 

14. How well does the area where you live help you achieve your health and wellbeing goals? (1 = very poor, 10 = excellent) *

 

15. What would help improve your own health and wellbeing and that of your family? Rate on scale of 1 (least helpful) to 10 (most helpful) how helpful each of the following would be: *

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Better access to open spaces
Closer community relations
Better access to primary care (GP) services
Better access to exercise/leisure/fitness support and facilities
Better access to mental health support
Better access to family support
Better access to citizens advice
Better access to housing advice
 

16. Is there anything else that you would like to tell us in relation to your health and wellbeing?

Check out our survey templates or create your own.
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