Age Friendly Community Survey Question Title * 1. What do you think are the most important areas in this model to get right for older people in Redbridge? (order from top to bottom - with top being the most important and bottom being the least important) Question Title * 2. Do you think there is anything missing in this model? (max 30 words) Question Title * 3. Is there one thing about living in Redbridge that you feel really helps older people live and age well? Question Title * 4. If you could ‘fix’ one barrier to older people in Redbridge being able to live and age well, what would it be? (max 30 words) Question Title * 5. Would you like to participate in further engagement to develop an age-friendly Redbridge? Yes No Question Title * 6. If yes, please provide your email or phone number? Question Title * 7. If yes, how would you like to be part of the conversation? Tick any that you would like: Small one-off focus group at a community venue Small focus group online Attending a larger public event (eg at a library or town hall) Someone coming to hold a conversation at a group you already attend Further in-depth surveys on specific subjects One to one conversation where you live One to one conversation on the telephone Taking part in an older people’s forum that meets regularly Tell my story Question Title * 8. Other – please say Question Title * 9. Please say if you have a specific area of interest you would like to be involved in Question Title * 10. Which borough in north east London do you live or work in? (please select one) Redbridge City of London Hackney Havering Newham Barking & Dagenham Tower Hamlets Waltham Forest Other Prefer not to say Question Title * 11. How old are you? (please select one) 16 and under 17 - 24 25 - 34 35 - 44 45 - 54 55 – 64 65 – 74 74 – 85 85+ Prefer not to say Question Title * 12. Which of the following options best describes how you think of yourself? (Please select one) Man (including trans man) Woman (including trans woman) Non-binary / third gender Prefer to self-describe Prefer not to say If you prefer to self-describe, please tell us your gender Question Title * 13. What is your ethnic group? Choose one option that best describes your ethnic group or background Asian or Asian British: Indian Asian or Asian British: Pakistani Asian or Asian British: Bangladeshi Asian or Asian British: Chinese Asian or Asian British: Any other Asian background Black, Black British, Caribbean or African:: African Black, Black British, Caribbean or African:: Caribbean Black, Black British, Caribbean or African:: Any other Black, African, or Caribbean background Mixed / multiple ethnic groups: White and Black Caribbean Mixed / multiple ethnic groups: White and Black African Mixed / multiple ethnic groups: White and Asian Mixed / multiple ethnic groups: Other mixed or multiple ethnic background White: English, Welsh, Scottish, Northern Irish or British White: Irish White: Irish Traveller White: Roma White: Any other white background Other ethnic group Prefer not to say Question Title * 14. If you selected an 'other' category - please describe Question Title * 15. Do you consider yourself to have a disability or long-term health condition? (please select as many as are relevant)? You’re disabled under the Equality Act 2010 if you have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities. Yes – a physical/mobility impairment Yes – a learning disability Yes – a mental health impairment No Prefer not to say Question Title * 16. Which of the following best describes how you think of yourself? (please select one) Bisexual Gay or lesbian Heterosexual / straight Prefer to self-identify Prefer not to say Question Title * 17. Is your sex the same as it was assigned at birth? (please select one) Yes No Prefer not to say Question Title * 18. Are you the main carer of a family member, partner or friend? (please select one) Yes No Prefer not to say Question Title * 19. Are you the parent or guardian of a child / children under the age of 18? (please select one) Yes No Prefer not to say Question Title * 20. Are you registered with a GP? (please select one) Yes No Prefer not to say Question Title * 21. Are you currently employed? (please select one) Full-time employed Part time employed Self-Employed Retired Student Unemployed (currently looking for work) Unemployed (currently not looking for work) Prefer not to say Done