Beat the Street Llanelli - Health Survey

Introduction

Thank you for taking part in Beat the Street. We hope you have lots of fun exploring and discovering Llanelli either on foot or by bicycle, scooter or wheelchair.

You'll earn 100 points for you and your team for telling us more about you and your activity levels. This should take no more than 5 minutes to complete.

Please ensure you are filling out this survey for the account you are logged into. If you are filling in the survey on behalf of a child, ensure you are logged into their account.

If you are aged 13 or under, you must complete this form with a parent or guardian and if you are 14 or 15, make sure you get your parent’s or carer’s permission to complete this survey. See our privacy policy.

Question Title

* 1. How old are you?

11 and under

12 - 18

19 - 29

30s

40s

50s

60s

70s

80+

Prefer not to say

Question Title

* 2. What is your ethnicity?

Question Title

* 3. Do you have a long-term medical condition (something like diabetes, asthma or high blood pressure)? You can choose more than one.

No

Yes - Diabetes

Yes - Heart Disease

Yes - COPD (emphysema)

Yes - Asthma

Yes - A mental health condition

Yes - Another long-term condition

Prefer not to say

Question Title

* 4. Do you have a disability which limits the activities or work you can do?

Yes

No

Prefer not to say