Parent / Carer Questionnaire | Let's Talk Monmouthshire

Part 1: General Information

How many children / young people with disabilities do you care for?

* required

3 +

How old are the children / young people with disabilities that you care for?

* required

0 - 5

6 - 10

11 - 15

16 - 18

What area of Monmouthshire do you live in?

* required

Monmouth and Surrounding Area (Grosmont, Skenfrith, Cross Ash, Llantilio Crossenny, Monmouth, Mitchel Troy, Trelleck, Llanishen)

Abergavenny and Surrounding Area (Pandy, Llanvihangel Crucorney, Abergavenny, Gilwern, Llanelly Hill, Govilon, Llanfoist)

The Heart of Monmouthshire (Raglan, Goytre, Little Mill, Usk, Llangybi)

Chepstow and Lower Wye Valley (Tintern, Devauden, Chepstow, Shirenewton, Caerwent)

Severnside(Magor, Undy, Rogiet, Caldicot, Portskewett)

What type of disabilities do the children / young people you care for have

Autistic Spectrum Conditions

Learning difficulty

Behaviour, emotional and social difficulties

Speech, language and communication needs

Hearing impairment

Multi-sensory impairment

Visual impairment

Physical disability

Additional complex medical needs

Wheelchair user

Totally dependant on having all intimate care needs met (specialist equipment i.e. hoist, large changing bed etc.)

Other (please specify)