We need your help
Brixton Advice Centre needs information on how the cost of living increases are affecting you so we can better understand the issues you and our community face, lobby for change, and better develop and target services provided by ourselves and others around Lambeth. Please help us by completing the short anonymous survey below

Sign in to Google to save your progress. Learn more
Please do not use this form to ask for advice, it is not monitored daily like our advice forms. If you need advice please contact us instead

This is an anonymous survey. We do not want to know your name or address and no-one will be able to identify you from your responses

It will only take a few minutes to complete but you are welcome to spend more time on it if you want to share more with us
Please tell us your Lambeth Ward

or select 'I don't know my Ward' at the bottom of the list below
 *
How concerned are you about the cost of living increases? *
Not at all concerned
Extremely concerned
Which rises in the cost of living are affecting you the most?  *
Required
Please feel free to tell us a little more about your selections below
Has your mental health been negatively impacted by rises in the cost of living? This might be how you feel about yourself and the future, or how you think you are coping *
You can tell us more about this here if you feel comfortable doing so
Tell us about any benefits you are receiving (please tick all that apply) *
Required
What are your main concerns regarding your future financial security? (Please tick all that apply) *
Required
You can tell us a little more about any particular concerns you have for your financial security here
Have you struggled to pay gas and/or electricity bills? *
Do you or your household pay for any of your energy through a pre-payment meter? *
If yes, you can tell us more about any issues you are having paying through a prepayment meter here
Have you used a foodbank in the last 12 months? *
If you have any thoughts about using foodbanks including whether you would use one in the future you can tell us below
Please tick all of the following statements that apply or select 'none of the above' *
Required
If you selected any of the statements above please tell us a little more about why below
The questions below help us think about whether some groups of people are experiencing certain issues differently to others and are very helpful to us. Please remember, this form is anonymous and we cannot identify you from your responses but if you still feel uncomfortable answering any of them just select 'prefer not to say'
What best describes your gender? *
What best describes your household? *
What best describes your current situation? *
What best describes where you live? *
What age group are you in? *
What best describes your ethnic group or background? *
Do you consider yourself to have a disability or a significant / long-term health condition? *
Please select any below that apply to you
You might have some suggestions you think we at BAC should take onboard. If you do, please tell us here
You might have some thoughts about what Lambeth Council or your Member of Parliament or others should be focussing on. If you do, please let us know here
If there is anything else you would like to tell us about how the cost of living is affecting you and the people you care about you can tell us here. Please do not include any of your personal information
Thank you for helping us with this survey. Please press the Submit button below
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Brixton Advice Centre. Report Abuse
Google Forms