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Are you a householder or homesharer?
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Householder
Homesharer
What stage of your Homeshare journey are you at?
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I’m about to begin my Homeshare match
I'm currently in my Homeshare agreement
My Homeshare agreement has ended
How old are you?
*
Please select
18-25
26-35
36-45
46-55
56-65
66-75
76-85
86-95
96+
What is your gender?
*
Please select
Male
Female
Other
Where are you in the UK?
*
Please select
North East
North West
Yorkshire & The Humber
East Midlands
West Midlands
East of England
London
South East
South West
Scotland
Wales
Northern Ireland
Which Homeshare provider are you registered with?
*
Please select
Homeshare Age UK Hillingdon, Harrow and Brent
Lightshare
Homeshare Living
Riverhouse Homeshare
Novus Homeshare
Share My Home
Two Generations
Cambridge Homehare
Homeshare UK Merseyside
Homeshare UK North East
Homeshare Oxfordshire
St John’s Winchester Homeshare
Homeshare Gloucestershire
Homeshare West
Homeshare Mendip
Homeshare Reading
Homeshare South West
Leeds Homeshare
Homeshare York
Shared Homes Swansea
Pembrokshire Homeshare
What is your ethnicity?
*
Please select
White
Mixed or Multiple ethnic groups
Asian or Asian British
Black, African, Caribbean or Black British
Other ethnic group
How safe and secure do you feel in your current living situation?
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Very safe
Quite safe
Not sure
Quite unsafe
Very unsafe
Why do you say that? (Optional)
Overall, how would you rate your physical health?
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Very good
Good
Not sure
Poor
Very poor
Why do you say that? (Optional)
How would you rate your overall mood?
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Excellent
Good
Average
Poor
Very poor
How would you rate your overall confidence?
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Excellent
Good
Average
Poor
Very poor
How would you rate your self-esteem?
*
Excellent
Good
Average
Poor
Very poor
If you would like to tell us more, please let us know in the box below. (Optional)
How often do you feel that you lack companionship?
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Hardly ever
Some of the time
Often
How often do you feel left out?
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Hardly ever
Some of the time
Often
How often do you feel isolated from others?
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Hardly ever
Some of the time
Often
How often do you feel lonely?
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Hardly ever
Some of the time
Often
Recently, how well have you managed your daily living tasks, such as preparing meals and cleaning your home?
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Very well
Quite well
Not sure
I struggle sometimes
I struggle often
Why do you say that? (Optional)
How connected do you feel to your local community?
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Very unconnected
Quite unconnected
Not sure
Quite connected
Very connected
How connected do you feel to online communities?
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Very unconnected
Quite unconnected
Not sure
Quite connected
Very connected
Why do you say that? (Optional)
Do you have enough money to do the things you want to do?
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I'm doing well financially
I'm quite stable financially
I'm doing okay
It can be a struggle
Not at all
Why do you say that? (Optional)
Overall, how would you rate your ability to lead the lifestyle you want?
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For example, eating well, having a clean home, being able to pursue your hobbies and interests, and having a good balance between household tasks, work and personal life.
Very satisfied
Satisfied
Not sure
Dissatisfied
Very dissatisfied
Why do you say that? (Optional)
Do you feel you spend enough quality time talking to or meeting with your family and friends?
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Lots of the time
Most of the time
Not sure
Not enough
Not at all
Not relevant to me
Why do you say that? (Optional)
