Have Your Say - Kent

Your story needs to be heard

Your story is powerful

Tell us your story and we can use it to make your health and social care services in Kent better.

What is your name?

We won’t share your name with any service

Tell us your story.

Try to include as much detail as possible. For example, we will need to know where it happened, which service and when.

It would really help us to know a bit more about you

If we need more detail about your story, how can we reach you?

Phone Number

Email Address

What gender do you identify as? *

How do you describe yourself?

Do you identify as Trans? *

Sexuality *

Other

Can you tell us how old you are? *

Are you 25?

Yes

No

What is your ethnic group? *

Ethnicity Other

What District do you live in? *

Are you a Carer? *

Are you a young Carer?

Yes

No

Do you have a disability or a health condition? *

Please tick all that apply

Physical Disability

Learning Disability

Mental Health

Long Term Health Condition (Please specify below if you wish)

Prefer not to say

Long Term Health Condition (Specified)

Is English your first language?

What is your first language?

Post Code *

Either your whole postcode or the first part only, whatever you prefer

Can we ask where you heard about Healthwatch Kent?

Thanks for telling us your story

We want to make sure your story drives positive change for everyone. To do that we need your permission. Are you happy for us to:

Record your story and share anonymously with decision makers so they can hear your voice.
Share your story with our sister organisations who are also working to improve services in Kent & Medway.
We won’t share your name or contact details with them.

I agree. *

Yes

Can we contact you to ask you more about this experience if needed? *

Yes

No

Are you happy to be contacted about other health and social care stories you may wish to share? *

Can we send you our monthly newsletter? *

Email for Newsletter *

If you would like any more info about how we collect and use your personal data check out our privacy policy here.