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Breathless
information sheets feedback survey
Thank you for taking the time to provide feedback on the
Breathless
information sheets. The information you provide through this questionnaire will help us to improve our resources. We really appreciate your feedback!
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1.
How would you describe your gender?
(Required.)
Female
Male
Non-binary
Transgender
Prefer not to say
I use a different term (please specify)
*
2.
What is your age?
(Required.)
Under 18
18-24
25-34
35-44
45-54
55-64
65+
3.
Do you identify as:
Heterosexual
Lesbian
Gay
Bisexual
Prefer not to say
I identify with a different sexual orientation (please specify)
*
4.
What country do you live in?
(Required.)
5.
How did you learn about the
Breathless
information sheets? (Select all that apply)
The
Breathless
website
Email
Social media
A friend or colleague
A service provider
Other (please specify)
*
6.
What is your interest in the
Breathless
information sheets? (Select all that apply)
(Required.)
Personal - for my own interest
Personal - I am interested as a parent or carer
Professional
Other (please specify)
*
7.
Reflecting on the
Breathless
information sheets, to what extent would you say they:
(Required.)
Not at all
A little
A lot
Were easy to understand
Not at all
A little
A lot
Provided helpful information
Not at all
A little
A lot
Included information that was new to me
Not at all
A little
A lot
Supported me to reflect on the issue of sexual strangulation
Not at all
A little
A lot
Any further comments on these questions?
8.
Is there anything in the
Breathless
information sheets that you found particularly
helpful
? If so, please specify (limit of 3500 characters)
9.
Is there anything in the
Breathless
information sheets that you found particularly
unhelpful
? If so, please specify (limit of 3500 characters)
10.
Do you think that the
Breathless
information sheets could be improved? If so, how?
11.
Is there something you will do differently because of these information sheets? If so, please share – be as brief, detailed, general or specific as you like: (limit of 3500 characters)
12.
Do you have any other comments or feedback? If so, please share. (limit of 3500 characters)
The
Breathless
team thanks you for your input!