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What age category are you?* required
What is your gender?* required
What is your ethnic group?* required
Are your day-to-day activities limited because of a health problem or disability which has lasted, or is expected to last, at least 12 months?* required
Do you have caring responsibilities? A carer is anyone who cares, unpaid, for a friend or family member who due to illness, disability, a mental health problem or an addiction cannot cope without their support.* required
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Which of these areas do you live in, or are closest to?* required
Would you like us to let you know about upcoming engagement and consultations? If yes, please let us know which organisation(s) you’d like to receive updates from.
We would like to contact you via email to send you information regarding future consultations and engagement exercises. Do you consent to us using your email for this purpose?
Would you be interested in being a part of an ongoing community panel/forum?
Are you a member of Powys County Council's People's Panel? (A group of residents that take part in surveys and other opportunities to express their views on council services and other issues related to living in Powys)* required

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