Healthwatch County Durham listens to people's experiences and gives you a voice on health and social care services. We want to learn more about your experience and knowledge of pharmacy services in your community. If you can answer these questions, your help would be appreciated. Thank you.

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* 1. How old are you?

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* 2. What is the first part of your postcode (e.g. DH1 or DL15)? This does not identify you but it helps us to see geographical trends in our data.

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* 3. Which of the following services do you think a pharmacy team can advise people on?

  Yes No Unsure
Weight management & lifestyle?
Medication?
Sexual health?
Stopping smoking?
Emergency contraception?
Alcohol awareness?
Drug addiction?
Minor ailment service?
Pregnancy testing?

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* 4. Have you ever accessed any of the following services through a pharmacy/chemist?

  Within the past week Within the past month Within the past 6 months Within the past 12 months Over 12 months ago Never
Weight management & lifestyle
Medication
Sexual health
Stopping smoking
Emergency contraception
Alcohol awareness
Drug addiction
Minor ailment service
Pregnancy testing

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* 5. Thinking about the following services, would you access any of them through a pharmacy/chemist?

  Yes No Unsure
Weight management & lifestyle
Medication
Sexual health
Stopping smoking
Emergency contraception
Alcohol awareness
Drug addiction
Minor ailment service
Pregnancy testing

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* 6. If anything, what would stop you accessing any of the services from a pharmacy/chemist? (Please tick all that apply)

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* 7. Is there anything that would make you more likely to use a pharmacy/chemist?

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* 8. Where would you look for information on something? (Please tick all that apply)

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* 9. Are you a young carer?

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* 10. Do you consider yourself to have a disability or additional needs?

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* 11. If you would like to enter our prize draw, please leave your contact details below

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