Centre for Independent Living NI: ILF NI Impact Evaluation

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for agreeing to take part in this project. We would like to reassure you that completing the survey will in no way affect your ILF award, and you can withdraw from the project at any stage without having to give a reason.
The following questions have been designed to explore your experiences as an ILF recipient or on behalf of the person who you manage an award on behalf of. There are no right or wrong answers as we are interested in learning from your thoughts, feelings and lived experiences. Please complete by 8th December 2019.

Question 1: Are you *

Male

Female

Prefer not to say

Question 2: How old are you? *

Question 3: Who do you live with? *

Parents

Partner / Spouse

Other family

Friends

Paid support worker

Alone

Question 4: What best describes your health condition or disability? Please tick all that apply.

Physical

Visual

Hearing

Learning

Speech / communication

Mental health

If you would prefer to describe your health condition or disability, please do so below:

Question 5: How long have you received your ILF award?

Question 6: How do you use your ILF Award? Please tick all that apply.

Employ a personal Assistant

Contract with an agency or service provider

Other

If you have selected other, please describe below

Question 7: What does Independent Living mean to you? Please describe in your own words.

Question 8: How does your ILF award contribute to your independence? Please describe in your own words

Question 9: What difference does ILF make to your life at home? Please describe in your own words

Question 10: What difference does ILF make to your life in the community? Please describe in your own words

Question 11: What difference does ILF make to your life in your health and emotional wellbeing? Please describe in your own words

Question 12: What difference does ILF make to your life in employment, education or training? Please describe in your own words

Question 13: What would life be like if you did not receive an ILF Award? Please describe in your own words.

Thank you for completing our survey and sharing your experiences of using an ILF award. If you would like to take part in the Personal Story section of our project, please leave your contact details below and someone will contact you to discuss further.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms