*1.Have you had to go without heating during the last 12 months through lack of money?(Required.)

Yes

No

*2.Can you keep your home adequately warm?(Required.)

Yes

No

*3.Have you been unable to pay bills (heating, electricity, gas) on time in the last 12 months due to financial difficulties?(Required.)

Yes

No

*4.For your hot water needs (e.g. showers, washing dishes) and cooking needs, do you feel that you can afford enough fuel/electricity?(Required.)

Yes

No

*5.How has the cost of energy impacted you? (Select all that apply to you)(Required.)

I have cut expenditure in other areas to afford energy costs

I have been worried about the costs of energy

I have moved to a pre-paid energy supplier

I (or someone in my household) has had bad health because the home is too cold

My electricity has been disconnected due to arrears in bills

I have been unable to switch supplier due to energy bill debts

I have switched supplier to get a cheaper price

I have been behind (in arrears) on my enegry bill

*6.If you struggle to keep the home adequately warm, can you share some of your experience? How does it impact you? How do you cope?(Required.)