One to One Questionnaire

Purpose of questionnaire
The purpose of this questionnaire is to understand your experience of Gender Outreach Service, a part of Leeds Gender Identity Service. We hope to use the information from this questionnaire to help understand what people find beneficial from their ONE TO ONE SESSIONS and learn what people feel could be improved in order to develop what is offered. Your ONE TO ONE SESSION may have taken place by telephone, online video or face to face with a Gender Outreach Worker. 

Participation
Completion of this questionnaire is optional. You have the right to not provide feedback. Your responses, or choosing not to participate, will not affect your care or treatment at the gender service in any way.

Anonymity
Please be aware that questionnaire responses are anonymous, meaning the answers you provide cannot be traced back to you (Please do not include your personal details, names of peers / others who used the service). As such, we are unable to withdraw the data you have provided after it has been submitted.

Further support:
Due to the anonymity of your response, we are unable to respond directly to you if you indicate that you are at risk of harm on your questionnaire answers. We also acknowledge that. We recommend the following if you require additional support:

You can discuss any difficulties with the questionnaire or be signposted to helpful services by contacting a Gender Outreach Worker.

Make an appointment with your General Practitioner (GP) to discuss what support is available in your area.

Samaritans offer a free listening service. They can be reached by telephone: 116 123, email: jo@samaritans.org and website: www.samaritans.org.

NHS 111 is available if you are unsure what to do and need advice.

In an emergency/crisis: attend your local Accident and Emergency (A&E) department or call 999.

If you require an easy read or large print version of this questionnaire, please contact a Gender Outreach Worker. Or if you have any questions about this questionnaire you can contact a Gender Outreach Worker on 0800 183 1486, or speak to a worker during a one to one session or group.