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1. Please indicate your gender:
Male
Female
Other

2. What was your age last birthday?
13 - 15
16 - 18
19 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65+

3. What are the first four digits of your postcode (e.g. NR31 7)? PLEASE WRITE IN (we will not be able to identify you from this)


4. Which of the following best describes you?
Single (i.e. not currently in a relationship)
In a new relationship – less than 1 month (not living together)
In a new relationship – 1-6 months (not living together)
In a long-term relationship i.e. 6 months or more (not living together)
In a relationship and living together
Married / civil partnership
Divorced / Separated
Widowed

5. And in general, how well informed do you feel people your age are about the sexual health and contraceptive services that are available to them in the local area?
Very well informed
Quite well informed
Neither nor
Not very well informed
Not at all informed
Don't know

6. What do you think would be the best way for a health service to communicate with you about sexual health and contraceptive issues?
A letter through my door
Through a medical professional (e.g. GP or nurse)
An event at a local venue (e.g. school/community centre)
Posters/leaflets in GP surgeries
Posters/leaflets in sexual health and contraceptive clinics
Posters/leaflets in schools/community centres
Personal, Social, Health & Economic Education (PSHEE) or Sex & Relationship Education (SRE) lessons
Billboards
Dedicated website
Pubs/clubs
Bus backs/sides
Local press
Social networking site (e.g. facebook, bebo, MySpace)
Don't know
Please specify

7. In general, to what extent do you think young people are aware that information and advice given at sexual health and contraceptive clinics are completely confidential i.e. are not passed on to anyone, including parents?
Very aware
Quite aware
Neither nor
Not very aware
Not at all aware
Don't know

8. What are your opinions about the provision of sexual health and contraception services in your local area? Would you say you are:
Very satisfied
Satisfied
Neither nor
Dissatisfied
Very dissatisfied
Don't know

9. Overall, how well informed do you feel about sexual health and contraception issues?
Very well informed
Quite well informed
Neither nor
Not very well informed
Not at all informed
Don't know

10. Additional comments