Online Survey - Parkinson’s Care and Support UK

Name*

Surname

D.O.B.*

Occupation

Address*

Email Address*

When were you diagnosed with Parkinson's?

What symptoms did you suffer from?

What treatments were you offered by your Neurologist or Doctor?

Were you ever given information on alternative treatments or therapies?

YES

NO

If yes, what information did you receive?

How did you discover Parkinson's Care and Support UK?

What made you choose Parkinson’s Care and Support UK Services?

Please Tick all relevant boxes.

FOR NEUROLOGICAL PHYSIOTHERAPY

Please Specify

After your diagnosis, have you been given a choice of treatments for your Parkinson’s? If so, what treatments?

Drug treatments

Non-drug treatments

A combination of both

Not sure

Did your doctor or Neurologist ever give you information on complementary or integrative therapies for Parkinson’s?

Yes

No

If yes, what information did you receive?

Do you take any medications for your Parkinson’s?

Yes

No

If Yes, What medications?

Please Specify

Have you been referred to a Neurological Physiotherapist before?

Yes

No

If Yes, was it by your local authority or privately?

If it was by the local authority, how long were you on the waiting list for?

Less than 2 weeks

4-6 weeks

6-12 weeks

More than 12 weeks (please specify)

Please specify

Please Specify

What made you choose Parkinson’s Care and Support UK Services?

How did you find our Neurological Physiotherapy application process?

Straight forward

Complicated

How long after applying for our service did your therapy start?

2-4 weeks

4-6 weeks

6-12 weeks

Over 12 weeks (please specify)

Please Specify

When did you start and finish receiving our Neurological Physiotherapy Service?

Start Date

End Date

Please Specify

Prior to starting our Neurological Physiotherapy service, which of the following motor symptoms did you struggle with

Since receiving Neurological Physiotherapy, which of the following motor symptoms have improved?

Prior to starting our Neurological Physiotherapy service, which of the following non-motor symptoms did you struggle with?

Since receiving Neurological Physiotherapy, which of the following non-motor symptoms have improved?

Since receiving Neurological Physiotherapy, which of the following areas have you seen improvement in?

What impact has our Neurological Physiotherapy had on your life?

Overall, do you feel that your symptoms have improved since having Neurological Physiotherapy?

Yes

No

Overall, do you feel that your wellbeing has improved since having Neurological Physiotherapy?

Yes

No

If yes how?

Overall, do you feel that you are able to do things more independently since having Neurological Physiotherapy?

Yes

No

If yes how?

What is the name of the Company that carried out your Neurological Physiotherapy?

What was the name of your therapist?

How did you find the initial home visit by your therapist?

Very Helpful and Necessary

Good

Necessary but I did not enjoy it

Overall, where you satisfied with their services?

Yes

No

Did you find our Neurological Physiotherapy service particularly helpful during the COVID19 pandemic?

Yes

No

Does not apply

Would you recommend our service to people with Parkinson's?

Yes

No

Why?

Have you ever donated to Parkinson’s Care and Support UK?

Yes

No

Have you ever volunteered for Parkinson’s Care and Support UK?

Yes

No

FOR RESPITE CARE

When did you start and finish receiving our Respite Care Service?

Start Date

End Date

Please Specify

Were you ever given any information on Carer’s allowance and eligibility by your local authority, NHS or other information?

Yes

No

If yes, by who?

Please Specify

What made you choose Parkinson’s Care and Support UK services?

Prior to starting our Respite Care service, were you receiving any of the following?

Please Specify

Do you feel your physical health and wellbeing have improved since using Parkinson’s Care and Support UK’s Respite Care?

Yes

No

If yes, to what degree has your physical health and wellbeing improved?

Slightly improved

Significantly improved

Slightly deteriorated

Significantly deteriorated

Can you tell us in which areas you have improved since taking our respite care? Tick the statements that apply to you (you can select multiple)

Respite care allowed me to do more exercise

Respite care allowed me to meet with friends (increase socialising)

Respite care allowed me to catch up on my hobbies

Respite care allowed me to do shopping

Respite care allowed me to catch up on sleep

Other (please specify)

Please Specify

Do you feel your social life has improved since using our Respite Care service?

Yes

No

Please state how much improvement you have gained?

Slight improved

Significant improved

Slight deteriorated

Significant deteriorated

Do you feel that our Respite Care service increased your independence?

Yes

No

Please state how much independence you gained?

Slightly more

Significantly more

I have not noticed any impact on my independence

What is the name of the Company that carried out your Respite Care?

What was the name of your carer?

How did you find the initial home visit by your carer?

Very Helpful and Necessary

Good

Necessary but I did not enjoy it

Overall, where you satisfied with their services?

Yes

No

Did you find our Respite Care service particularly helpful during the COVID19 pandemic?

Yes

No

Does not apply

Please give a brief description on how it has helped you

Would you recommend our service to people affected by Parkinson's?

Yes

No

Why?

Do you know how to donate to Parkinson’s Care and Support UK?

Yes

No

Have you ever donated to Parkinson’s Care and Support UK?

Yes

No

Have you ever volunteered for Parkinson’s Care and Support UK?

Yes

No

FOR Parkinson’s Exercises

Please Specify

After your diagnosis, have you been given a choice of treatments for your Parkinson’s? If so, what treatments?

Drug treatments

Non-drug treatments

A combination of both

Not sure

Did your doctor or Neurologist ever give you information on complementary or integrative therapies for Parkinson’s?

Yes

No

If yes, what information did you receive?

Do you take any medications for your Parkinson’s?

Yes

No

If Yes, What medications?

Please Specify

Were you ever given information on exercise?

Yes

No

If yes, what information did you receive?

Have you been referred to a neurological physiotherapist before?

Yes

No

If Yes, was it by your local authority or privately?

If it was by the local authority, how long were you on the waiting list for?

Less than 2 weeks

4-6 weeks

6-12 weeks

More than 12 weeks (please specify)

Please Specify

Before your diagnosis, were you physically active?

Yes

No

Please Specify

How would you describe your activity levels?

Highly active

Moderately active

Not active at all

Other (please specify)

Please Specify

What made you choose Parkinson’s Care and Support UK Services?

When did you joined our Parkinson’s Specialist exercise classes?

Prior to starting our Parkinson’s Specialist Exercise Classes, have you found it hard to exercise?

Yes

No

Please Specify

Prior to starting our Parkinson’s Specialist exercise classes, which of the following motor symptoms did you struggle with

Since starting our Parkinson’s Specialist exercise classes, which of the following motor symptoms have improved?

Prior to starting our Parkinson’s Specialist exercise classes, which of the following non-motor symptoms did you struggle with?

Since starting our Parkinson’s Specialist Exercise Classes, which of the following non-motor symptoms have improved?

Since starting our Parkinson’s Specialist Exercise Classes, which of the following areas have you seen improvement in?

Do you feel your physical health and wellbeing have improved since starting Parkinson’s Care and Support UK’s Specialist ExerciseClasses?

Yes

No

If yes, to what degree has your physical health and wellbeing improved?

Slightly improved

Significantly improved

Slightly deteriorated

Significantly deteriorated

Can you tell us in which areas you have improved since starting our Parkinson’s Specialist Exercise Classes? Tick the statements that apply to you (you can select multiple)

Please Specify

Do you feel your social life has improved since attending our Parkinson’s Specialist Exercise Classes?

Yes

No

Please tick how much improvement you have gained?

Slight improved

Significant improved

Slight deteriorated

Significant deteriorated

What impact has our Parkinson’s Specialist Exercise Classes had on your life?

Overall, do you feel that your symptoms have improved since attending Parkinson’s Specialist Exercise Classes?

Yes

No

Overall, do you feel that your wellbeing has improved since attending Parkinson’s Specialist Exercise Classes?

Yes

No

If yes how?

Overall, do you feel that you are able to do things more independently since attending Parkinson’s Specialist Exercise Classes?

Yes

No

If yes how?

Do you think you get motivated by our instructors?

Yes

No

How?

What is the name of your instructor?

Overall, are you satisfied with their services?

Yes

No

Did you find our Parkinson’s Specialist Exercise Classes particularly helpful during the COVID19 pandemic?

Yes

No

Does not apply

Would you recommend our Exercise Classes to people with Parkinson's?

Yes

No

Why?

Have you ever donated to Parkinson’s Care and Support UK?

Yes

No

Have you ever volunteered for Parkinson’s Care and Support UK?

Yes

No

FOR Parkinson’s Therapies

When have you started receiving these Services?

Start Date

When have you stop receiving these Services?

End Date

Please Specify

Were you ever given any information on this therapyand eligibility by your local authority, NHS or other information?

Yes

No

If yes, by who?

Please Specify

What made you choose Parkinson’s Care and Support UK services?

Prior to starting our Therapy, were you receiving any other therapies?

Yes

No

If yes, what therapies?

Do you feel your physical health and wellbeing have improved since using Parkinson’s Care and Support UK’s Therapy?

Yes

No

If yes, to what degree has your physical health and wellbeing improved?

Slightly improved

Significantly improved

Slightly deteriorated

Significantly deteriorated

If yes, to what degree has your physical health and wellbeing improved?

Slightly improved

Significantly improved

Slightly deteriorated

Significantly deteriorated

If yes, to what degree has your physical health and wellbeing improved?

Slightly improved

Significantly improved

Slightly deteriorated

Significantly deteriorated

If yes, to what degree has your physical health and wellbeing improved?

Slightly improved

Significantly improved

Slightly deteriorated

Significantly deteriorated

If yes, to what degree has your physical health and wellbeing improved?

Slightly improved

Significantly improved

Slightly deteriorated

Significantly deteriorated

Can you tell us in which areas you have improved since using our therapy?

Do you feel your overall life has improved since using our therapy?

Yes

No

Please state how much improvement you have gained?

Slight improved

Significant improved

Slight deteriorated

Significant deteriorated

Please state how much improvement you have gained?

Slight improved

Significant improved

Slight deteriorated

Significant deteriorated

Please state how much improvement you have gained?

Slight improved

Significant improved

Slight deteriorated

Significant deteriorated

Please state how much improvement you have gained?

Slight improved

Significant improved

Slight deteriorated

Significant deteriorated

Please state how much improvement you have gained?

Slight improved

Significant improved

Slight deteriorated

Significant deteriorated

Do you feel that our therapy increased your independence?

Yes

No

Please state how much independence you gained?

Slightly more

Significantly more

I have not noticed any impact on my independence

Please state how much independence you gained?

Slightly more

Significantly more

I have not noticed any impact on my independence

Please state how much independence you gained?

Slightly more

Significantly more

I have not noticed any impact on my independence

Please state how much independence you gained?

Slightly more

Significantly more

I have not noticed any impact on my independence

Please state how much independence you gained?

Slightly more

Significantly more

I have not noticed any impact on my independence

What was the name of your therapist?

How did you find the initial assessment and service by your therapist?

Very Helpful and Necessary

Good

Necessary but I did not enjoy it

Overall, where you satisfied with their services?

Yes

No

Did you find our Therapy particularly helpful during the COVID19 pandemic?

Yes

No

Does not apply

Please give a brief description on how it has helped you

Would you recommend our service to people affected by Parkinson's?

Yes

No

Why?

Do you know how to donate to Parkinson’s Care and Support UK?

Yes

No

Have you ever donated to Parkinson’s Care and Support UK?

Yes

No

Have you ever volunteered for Parkinson’s Care and Support UK?

Yes

No

Please Specify

When have you started receiving these Services?

Start Date

When have you stop receiving these Services?

End Date

How many sessions have you received?

Prior to starting using our services, what motor symptoms did you struggle with most and how they affect daily life?

What impact our services had on your life?

Have your symptoms improved?

Have our services had impact on your well being?

Yes

No

If so how?

Have our services had impact on your independent?

Yes

No

If so how?

If you have received Physiotherapy, Respite Care, Companionship. What is the name of the Company that carried out your service?

What was the name of your therapist or carer?

Where you satisfied with their services?

How helpful has our service been during the COVID19 pandemic?

Would you recommend our service to people with Parkinson's?

Yes

No

Why?

We constantly strive to improve our services. What feedback, good or bad, can you give to Parkinson's Care and Support UK?

Date of survey

Parkinson’ Care and Support UK Services User Satisfactory Survey

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Parkinson’ Care and Support UK
Services User Satisfactory Survey