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* 1. Of the services listed below, do you use any of the services and how well do they meet your needs?

  Do not use Not at all Not very well Very Well Good Excellent
General practice
Pharmacies
Hospitals
Accident & emergency
Specialist services for long term conditions
Counselling
Sexual health or GM clinic

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* 2. Of the services you use, which do you think is the most accessible and the least accessable? ( 1 being the least accessible & 10 being the most accessible)

  1 2 3 4 5 6 7 8 9 10
General practice (GP)
Pharmacies
Hospital
Accident & emergency
Specialist services for long term conditions
Counselling services
Sexual health or GUM

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* 3. How do you think it is best to seek young peoples views about health & wellbeing? ( 5 being the best and 1 being the least)

  1 2 3 4 5
Small focus group ( less than 10 people)
Large focus group ( more than 10 people)
Meetings or activities led by adults ( more adults than young people)
Meetings or activities where adults and young people are equal
Meetings or activites led by young people ( more young people than adults)

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* 4. What part of the service development or improvement do you think it is useful for young people to be involved in? (tick all that apply)

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* 5. What would stop you from giving feedback or making complaints about services? ( tick all that apply)

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* 6. What would make it easier to give feedback or make complaints about services? (tick all that apply)

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* 7. Age

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* 8. Are you male or female?

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* 10. Please enter your details below if you would be interested in developing a young patient forum.

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