Aim and objectives of the report - CLES
Aim and objectives of the report - CLES
Aim and objectives of the report - CLES
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Are you receiving benefits because <strong>of</strong> a health problem or disability?YesNoWhich <strong>of</strong> <strong>the</strong> following best describes your current situation?Live aloneLive with partner <strong>and</strong> childrenLive with partnerLive with a relative (e.g. a parent)O<strong>the</strong>r (Please say):Are you a carer for someone with disability or health needs?YesNoIf Yes please give details:Accommodation:Own homeCouncil or housing associationPrivate rentedNursing/ResidentialO<strong>the</strong>r (Please say):Which <strong>of</strong> <strong>the</strong> following best describes your current situation?At schoolRetiredSeeking to workFull time looking after home or familyFur<strong>the</strong>r Education/TrainingEmployedSelf employedO<strong>the</strong>r (Please say below)Emergency ContactTel No:Name:GP SurgeryName:OFFICE USE218 SWWB Final Evaluation Report