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This survey will take you about 15 minutes to complete. It will help The Somerville Foundation to understand how we can best improve our services and communication to you. We will not share your personal details with anyone and really appreciate your help.

Thank you.

* 1. Are you completing this survey as a

If you are completing this and do not have a CHD youself please answer only those questions you feel are appropriate. Thank you.

* 2. A bit about you..

* 3. How old are you?

* 4. How would you describe your ethnic origin?

* 5. Are you male or female?

* 6. Do you have any children that you usually care for?

* 7. Do you have any other relatives that you usually care for?

* 8. Do you describe yourself as

* 9. Were you born with a heart condition?

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

Now onto the real questions....

* 11. How do you feel about managing your CHD?

* 12. Have you ever...

* 13. Would you find the following useful to help you manage your condition?

* 14. Would you like guidance to help you to talk about your CHD to:

* 15. My biggest worry about my CHD is...

* 16. My greatest barrier in life created by my CHD is...

* 17. What would help you feel better about living with your CHD?

* 18. What would help you think positively about living with your CHD?

* 19. What other services would you like to see The Somerville Foundation develop to help you?

* 20. How do you like to get your information?

* 21. Where would you want to use this information?

* 22. Where do you like to learn more about CHD and support available?

* 23. What should The Somerville foundation do more of?

* 24. What should The Somerville foundation do less of?

* 25. How likely would you be to recommend The Somerville Foundation to a friend or colleague affected by CHD?

* 26. Would you be prepared to help fundraise for The Somerville Foundation?

* 27. What would help you to fundraise on our behalf?

Thank you very much for helping us to improve our services to you.

Please don't forget to click the DONE button below.

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