Cudox Wellbeing CIC- Your views of therapy in North East Lincolnshire

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Our mission is to ensure that anyone in North East Lincolnshire, needing person-centred therapy is able to access it regardless of their situation in life.

This questionnaire is anonymous and information you provide will be used to help us to better understand the needs of our community and identify gaps in mental health services.

We may use information in applications for funding and promotional material.

If you have any questions or accessibility requirements and would like this questionnaire in a different format, please contact info@cudox.co.uk or call 01472 289838

Therapy, this is the umbrella term used for counselling and psychotherapy.

Please read the following statements and indicate whether you are willing/able to take part in the questionnaire:

I have read and understood the information provided and understand what is involved in taking part in this piece of research, and how the information I provide will be use

I understand all data collected is anonymously and I only have to share the data I wish to provide

I know who/where to ask any questions about the research or my participation

I am aware I can withdraw from this study by closing my browser

I understand that my data will be stored securely and handled in line with Cudox's data protection policy which is available upon request

I agree to being quoted anonymously in reports and publications related to this project.

I have read and understood the above information and consent to taking part in this research questionnaire. *

Yes

Required

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms