At what point were you identified as a carer/family member/supporter when the person you support engaged with our services?

On Admission or Initial Appointment Within 1 month of Admission or Initial Appointment Within 6 months of Admission of Initial Appointment Other

If other, please confirm

Did you feel listened to and valued as a carer/family member/supporter?

Yes No

If you answered no, please provide further information

Did you feel you were involved with the treatment and informed of any changes about the person you support?

Yes No

If you answered no, please provide further information

Were you provided with support from the service and/or signposted to relevant support services in the Community?

Yes No

If you answered no, please provide further information

Would you like to go to a clinic that is friendly and supportive of LGBTQIA+ people?

Yes No I do not mind Not sure

If you want to, please tell us the reason for your answer

Which do you like better?

Walk-in clinics (you just turn up) Appointments you book in advance I do not mind It depends Other

Please state

How do you feel about using sexual health services?

Very comfortable Quite comfortable Neither comfortable or uncomfortable Quite uncomfortable Very uncomfortable Not sure

Have you ever avoided or put off going to a sexual health clinic because you were worried about being treated unfairly?

No Yes Prefer not to say

Do you feel staff understand LGBTQIA+ sexual health needs?

Definitely Yes Yes, to some extent No, not really Definitely No Not sure

How important is it that staff use the right name, pronouns, and respectful language?

Very important Quite important Neither important or unimportant Quite unimportant Very unimportant Not sure

Do things like pronoun badges or inclusive posters help you feel welcome?

Yes No It makes no difference Not sure

Have you had any problems getting sexual health care? (You can choose more than one.)

A bad past experience Cost I have had no problems Long waiting times Other Staff not understanding LGBTQIA+ people Travel or location

Do you feel okay telling staff about your sexual orientation or gender identity?

Yes Sometimes No Prefer not to say

Do our forms let you write your name, pronouns, and gender the way you want?

Yes Sometimes No Not sure

What is your age group?

Under 18 18 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75+

To which of these ethnic groups would you say you belong?

Please type the first few letters... Asian or Asian British - Any other Asian background Asian or Asian British - Bangladeshi Asian or Asian British - Indian Asian or Asian British - Pakistani Black or Black British - African Black or Black British - Any other Black background Black or Black British - Caribbean Mixed - Any other mixed background Mixed - White and Asian Mixed - White and Black African Mixed - White and Black Caribbean Not known Not stated Other Ethnic Groups - Any other ethnic group Other Ethnic Groups - Chinese White - Any other background White - British White - Irish White

To which gender identity do you most identify?

Female Male Transgender Female Transgender Male Intersex Non-Binary Gender-Fluid Gender Neutral Agender Pangender Gender Queer Prefer not to say

What is your sexual orientation?

Heterosexual or Straight Gay Lesbian Bisexual Asexual Pansexual Queer Don't know Prefer not to say

Do you consider yourself to have a disability?

Yes No

If you answered yes, please indicate your disability (you can select more than one option)

Vision (e.g. due to blindness or partial sight) Hearing (e.g. due to deafness or partial hearing) Mobility (e.g. such as a physical impairment, difficulty walking short distances, climbing stairs, lifting and carrying objects, needing an aid) Learning or concentrating or remembering Mental Health Stamina or breathing difficulties Social or behavioural issues (e.g. due to neurodiverse conditions such as Autism, Attention Deficit Disorder or Asperger's Syndrome) Chronic Fatigue Chronic Pain Prefer not to say