Thank you for taking part in our digital project.
To help us measure and report on the project, please complete the following questions.
Please be open and honest in your feedback.

Name

First

Last

By filling in the details you are granting consent to adding your information to our database.

Email

How confident are you using computers?

Selected Value: 0

How confident are you using mobile devices?

Selected Value: 0

How would you rate your ability to use online forms for personal health?

Selected Value: 0

How would you rate your ability to use online forms for personal finance?

Selected Value: 0

How confident are you using email?

Selected Value: 0

How would you rate your ability to socialise with people online (for example: emailing, Facetime, Whatsapp, Zoom etc)?

Selected Value: 0

How would you rate your ability to identify what your next learning steps might be and the support you need?

Selected Value: 0

(For the last question – Do you know what specific digital support you need help with, if yes – score yourself high, if no – score yourself low)

Selected Value: 0

Regarding completing forms online – please give exampes of the types of forms or services you can now access:

e.g. e-consult, booking your covid vaccine, online banking, your finances; anything else?

If you are more confident using emails, what difference has this made to you?

If you are more confident socialising online what difference has this made to you?

Please tell us more. . .

Was the experience of being supported by a Digital Champion what you expected?

• Yes
• No

Anything else you would like to share about your experience with a Digital Champion?

GDPR Agreement – I consent to having this website store my submitted information so they can respond to my inquiry.

• Yes
• No

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