Information and Advice Survey

About you

Question Title

* 1. Gender

Male

Female

Transgender

Prefer not to say

Other (please specify)

Question Title

* 2. Age

-59

60-69

70-79

80-89

90+

-59

60-69

70-79

80-89

90+

Question Title

* 3. Please select your Local Authority

Anglesey

Blaenau Gwent

Bridgend

Caerphilly

Cardiff

Carmarthenshire

Ceredigion

Conwy

Denbighshire

Flintshire

Gwynedd

Merthyr Tydfil

Monmouthshire

Neath Port Talbot

Newport

Pembrokeshire

Powys

Rhondda Cynon Taf

Swansea

Torfaen

Vale of Glamorgan

Wrexham

Outside of Wales

Question Title

* 4. What is your ethnicity? (Please select all that apply.)

Asian

Black

Chinese

Mixed/ Multiple Ethnic Groups

White

None of the above, please specify...

Question Title

* 5. Do you consider yourself to have a disability?

Yes

Prefer not to say

Yes

Prefer not to say