* 1. How many Male & Females in your Household ? Please specify numbers.

* 2. What age group are the occupants from your household in ? Please specify numbers.

* 3. What area do you live in ?

* 4. How would you describe your households ethnic origin ? Please specify numbers.

* 5. How would you describe your households religion ? Please specify numbers.

* 6. How would you describe your households sexuality? Please specify numbers.

* 7. How many people in your household could be described as the following. Please specify numbers

* 8. How often do the adults in your household visit your GP ?

* 9. How often do the children/adult dependents in your household visit your GP ?

* 10. How often do the adults in your household have hospital/specialists appointments ?

* 11. How often do the children/adult dependents in your household have hospital/specialists appointments ?

* 12. How often do the adults in your household visit the dentist ?

* 13. How often do the children/adult dependents in your household visit the dentist ?

* 14. How often do the adults in your household visit the hygenist ?

* 15. How often do the children/adult dependents in your household visit the hygenist ?

* 16. How often do the adults in your household visit the opticians ?

* 17. How often do the children/adult dependents in your household visit the opticians ?

* 18. Which of the following weight group are the adults in your household in ?

* 19. Which of the following weight group are the children/adult dependents in your household in ?

* 20. What food types do the adults in your household consume ?

* 21. What food types do the children/adult dependents in your household consume ?

* 22. What other food types do the adults in your household consume ?

* 23. What other food types do the children/adult dependents in your household consume ?

* 24. How long do the adults in your household exercise for per day ?

* 25. How long do the children/adult dependents in your household exercise for per day ?

* 26. What type of exercise do the adults in your household do ?

* 27. What type of exercise do the children/adult dependents in your household do ?

* 28. Do any of the adults in your household access community activities ?

* 29. Do any of the children/adult dependents in your household access community activities ?

* 30. Do any of the adults in your household access any of these support organisations ?

* 31. Do any of the children/adult dependents in your household access any of these support organisations ?

* 32. How do the adults in your household access these support organisations ?

* 33. How do the children/adult dependents in your household access these support organisations ?

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