Questionnaire

Health and Care Services - We want to know your experiences.

The Blackburn with Darwen 50+ Partnership has been asked to find out what people's recent experiences of local health and care services have been like. If you are aged over 50, live in the Borough of Blackburn with Darwen and have used a local health or care service recently, then we want to know what you thought. The information that you provide us will be used to build a general picture of over 50s experiences and will be reported to local health and care services. Individual information that could be used to identify a particular person will not be reported.

Which service did you use?

Please feel free to list as many services as you wish to comment on.

When did you use this service?

Approximate dates are helpful if you are unsure of exact timings.

Please use this box to give details of your experience

Please feel free to write as much as you like. This textbox will expand.

Please provide the following information so we can identify issues that affect particular people or parts of the Borough

Age

Post Code

Ethnicity White Asian Other

Gender Male Female