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* 1. Are you taking this for yourself or someone you care for? If it’s for someone else we will refer the questions to ‘you’.

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* 2. When did you last use a Mersey Care service ? If you have not used a Mersey Care Service since February 2020 please go to question 4.

Date

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* 3. Which services of Mersey Care have you used (if any)?

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* 4. Have you experienced any changes to your healthcare due to the pandemic?

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* 5. If yes, how would you rate the communication received about the changes?

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* 6. If this relates to a specific service please tell us the name of this service (leave blank if you’d prefer not to say)

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* 7. Could you tell us more about your experience of these changes?

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* 8. Overall, how was your experience of our service?

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* 9. How much of an impact has the pandemic had on your mental health or wellbeing?

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* 10. Have you been able to access support for your mental health or wellbeing during this time?

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* 11. Would you like to tell us more about this? If you feel you need urgent help now please contact your GP or call the Samaritans free on 116 123.

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* 12. Mersey Care NHS Foundation Trust is dedicated to involving patients in their own care. We would like your feedback and any suggestions on how we can improve.

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* 13. Is there anything else you’d like to tell us?

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* 14. By telling us more information about yourself, you can help us better understand how people's experiences may differ depending on their personal characteristics. However, if you do not wish to answer these questions you do not have to.
Please tell us which age category you fall into?

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* 15. Please tell us which gender you identify with

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* 16. Is your gender different to the sex that was assigned to you at birth?

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* 17. Please select your ethnic background

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* 18. Please tell us which sexual orientation you identify with

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* 19. Please tell us about your religion or beliefs

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* 20. Please tell us about your marital or civil partnership status

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* 21. Are you currently pregnant or have you been pregnant in the last year?

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* 22. Do you (or the person you are taking the survey for) consider yourself to be a carer, have a disability or a long term health condition? (Please select all that apply)

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* 23. Do you consider yourself to be confident at using a computer or mobile phone for looking for information online?

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* 24. Do you consider yourself to be confident at using a computer or mobile phone for sending a message to another person via email or online messaging service?

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* 25. Do you consider yourself to be confident at using a computer or mobile phone for using an online consultation service for your appointments (where appropriate)?

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* 26. Do you have access to:

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