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Hi There,

We are setting up a service for families affected by a loved one's drug or alcohol use. You could be a parent, husband, wife, brother or sister, partner or anyone that is important to you. 

You are invited to participate in our survey and we are hoping to get as many responses as we can from people in a similar situation to you. The questions are about you, your loved one and what would be important to you as a service. It shoud take no more than 30 minutes to complete (this depends on how much detail you give).

Your participation in this study is completely voluntary. There are no risks associated with this project. However, if you feel uncomfortable answering any questions, you can leave that particular question out. If possible, it would be fantastic to hear your views and learn a bit about you. 

Your survey responses will be strictly confidential and data from this research will be dealt with on an anonymous basis. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact us by email at [email protected].

Thank you so much for your time. There is an option at the end to leave your email address if you wish to be added to our mailing list for updates on the service. You can also access our facebook page on xxxx.



 
 
 
 
All About You.
 
 
 
What do you identify your gender as?
 
 
 
What is your age?
 
0-15
 
16-24
 
25-34
 
35-44
 
45-54
 
55-64
 
65-74
 
75-84
 
85+
 
 
 
What is your highest level of education?
 
Degree or equivalent
 
Higher Education
 
A Level or equivalent
 
GCSE or equivalent
 
Other Qualifications
 
 
 
How would you best describe your employment status at present?
 
Employed
 
Unemployed
 
Retired
 
Other
 
 
 
About Your Loved One
 
 
 
The person who's drug or alcohol use I am concerned about is my...
 
Spouse
 
Civil Partner
 
Cohabiting partner
 
Son/daughter (incl. adopted)
 
Step-son/daughter
 
Foster child
 
Son-in-law/daughter-in-law
 
Parent/guardian
 
Step-parent
 
Foster parent
 
Parent-in-law
 
Brother/sister (incl. adopted)
 
Step-brother/sister
 
Foster brother/sister
 
Brother/sister-in-law
 
Grandchild
 
Grandparent
 
Other relative
 
Other non-relative