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Contact Tel.

Emergency Contact Name, Tel & Relationship.

Which gender do you identify as?

Which gender do you identify by?

Email Address (please double check you've entered this correctly)*

How did you hear about FYF?

If you selected other above, please tell us more here.

What is your local authority area?

Which hospital carried out your amputation?

What year was your amputation?

GP Name. Address & Tel.

Do you have any form of professional support? E.g. a support worker, social worker, psychiatric or mental health worker etc....

Would you like to tell us more about the professional support you receive?

Reason for Amputation

Would you like to tell us more about the reason for your amputation?

Any Additional Limb Information

Any other information.

Feedback:

Which product (s) did you purchase?

Were you happy with the process?

On a scale of zero (unlikely) to ten (very likely), how likely would you be to recommend us to friends or family?

On a scale of zero (unlikely) to ten (very likely), how likely would you be to recommend our shop / merchandise to friends or family?

How did you hear about FYF?

If you selected other above, please tell us more here.

Which type of club did you attend?*

Which area did you attend?*

Which club did you attend?*

Which platform was your club held on?

Which platform do you prefer and why?

Is there any other way we could help you connect to our online activities?

How beneficial did you find the club?*

With reference to your last answer, would you like to leave a comment?

Any ideas or suggestions to change/improve the club?

Do you have any suggestions for new clubs?

Please write your suggestions below.

Would you recommend these sessions to others?*

Has your self esteem increased by taking part in this club?*

Which gender do you identify as?*

What gender do you identify by?

Which age range do you fall into?*

If you made use of the FYF transport, would you still attend if this was not available?*

Any additional comments?

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Thank you very much for your purchase and your feedback.

Thank you for your feedback. We will use the results to our clubs survey to ensure you get the most out of the clubs we run, and also in applying for funding to continue running clubs like this. Thank you.

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