Lympne Women's Health Project
The Lympne Women's Health project aims to support all women, living in Lympne, with their health and wellbeing.  This questionnaire is to get an overview of what life stage you are at, what your current health and wellbeing is like and what you would like help with.
All questionnaires are anonymous and confidential.
Sign in to Google to save your progress. Learn more
Do you currently live in Lympne? *
If No to the above, where do you live?
Please indicate which age range you are in. *
Do you have a registered Disability?  If yes, please tell us below what it is. *
Are you a parent and/or a carer?  If Yes, are you interested in carer and/or parent support?  Please tell us below. 
When you think about your health, have you had any significant health issues?  Please list them below. *
How have you been supported with those health issues? *
Looking more closely at Women's Health and wellbeing, have you had any issues e.g. issues with periods, pregnancy, menopause, bladder issues and anything else considered gynaecological (Women's Health)?  *
How have you been supported with those health issues? *
Are you currently on any medication?  If Yes, please indicate below what medication you are taking and what it is for. *
Are there specific areas of Women's Health that you would like support with and to understand better? *
Is there anything else you would like to share with us that you feel is relevant to your health, Women's Health or the Lympne Project? *
Thank you for taking the time to complete this questionnaire.  Your answers will help us to tailor the Lympne Women's Health Project for your needs.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms