NEW ASC user research sign up form

Join our research panel and help shape improvements to Kingston Council's Adult Social Care services
Join our user research panel to receive invites to activities and surveys to help shape future improvements to Kingston Council services.

It'll take approximately 5 minutes to complete this form. We'll email you if you're selected to take part.

Please note that to be on the register you must:
- be over 18
- live or work in the borough of Kingston
- not be employed by Kingston or Sutton councils
Data Privacy

We only collect data for Kingston Council research purposes. We store all data securely and do not share it with other organisations. For our full privacy notice go to kingston.gov.uk/privacy. To opt out at any time, contact research@kingston.gov.uk.
Email*
example@example.com
Name*

First NameLast Name
Do you live in the Royal Borough of Kingston Upon Thames?*

YesNo
Do you work for Kingston and/or Sutton Council?*

YesNo
Unfortunately you do not meet the criteria for our research. We cannot add you to the register if you work for Kingston or Sutton council.
About you

Collecting personal details helps us understand who our participants are and ensures that our research is diverse and inclusive. By telling us about yourself we can make sure we only ask you to take part in research that is relevant to you. Sharing this information helps us understand more about the range of people that live in Kingston.
What is your date of birth?

DayMonthYear
For example 01-06-1960
What is your sex?

FemaleMalePrefer not to sayOther
Is the gender you identify with the same as your sex registered at birth?

YesNoPrefer not to sayOther
What is your ethnic group?

White - English / Welsh / Scottish / Northern Irish / BritishWhite - IrishWhite - Gypsy or Irish TravellerWhite - Any other White BackgroundMixed / Multiple ethnic groups - White & Black CaribbeanMixed / Multiple ethnic groups - White & Black AfricanMixed / Multiple ethnic groups - White & AsianMixed / Multiple ethnic groups - Any other Mixed / Multiple ethnic backgroundAsian or Asian British - IndianAsian or Asian British - PakistaniAsian or Asian British - BangladeshiAsian or Asian British - ChineseAsian or Asian British - Sri LankanAsian or Asian British - KoreanAsian or Asian British - Any other Asian backgroundBlack / African / Caribbean / Black British - CaribbeanBlack / African / Caribbean / Black British - AfricanBlack / African / Caribbean / Black British - Any other backgroundOther ethnic group - ArabPrefer not to sayOther
What is your employment status?

In educationEmployed full-timeEmployed part-timeUnemployedRetiredPrefer not to sayOther
Accessing the internet

Knowing how you access the internet, whether through different devices or networks, helps us design research activities that are compatible with your technology setup.
How do you typically access the internet?

Desktop computerLaptop computerTablet (e.g iPad)Smartphone (e.g. iPhone, Samsung Galaxy)None of the aboveOther
How often do you typically use the internet?

Several times a dayAt least once a daySeveral times a weekSeveral times a monthOnce a month or less
How confident are you at taking part in a video call?

1

2

3

4

5

1 is Not at all confident, 5 is Very confident
How confident are you at sharing your screen on a familiar device?

1

2

3

4

5

1 is Not at all confident, 5 is Very confident
Do you have access to a reliable internet connection?

YesNoI don't know
Accessibility

Questions about accessibility help us create research experiences that cater to participants with various needs and abilities. By understanding your accessibility requirements, we can adapt our methods and materials to ensure everyone can participate comfortably.
Do you have any physical or mental health conditions or illnesses lasting or expected to last 12 months or more?

YesNoPrefer not to say
Do you have any health conditions which affect you in the following areas? Please tick all that apply.

Blind or have a visual impairment uncorrected by glassesD/deaf or have a hearing impairmentNeurodiversity such as Autism, ADHD, ADD, dyslexia, dyscalculia and dyspraxiaLong term illness or health condition, such as cancer, HIV/AIDS, heart disease, diabetes or epilepsyMental health condition, challenge or disorder, such as depression, schizophrenia or anxietyPhysical impairment (a condition that substantially limits one or more basic physical activities such as walking, climbing stairs, lifting or carrying)Social / communication conditions such as a speech and language impairment or an autistic spectrum conditionPrefer not to sayNoneOther
Do you need any software or equipment to help you use the internet?

Screen magnifier (software that enlarges your screen)Screen reader (software that reads out a webpage)Voice control software (control your computer using voice)Adjust colours / contrast on webpagesNone of the aboveOther
Experience with adult social care

Knowing your experience with adult social care helps us to know which research opportunities would be most suitable.
What is your experience of adult social care?*

I am a carer for a friend or relativeI live at home but I have care needsI live in a care homeOther
Where are you currently in the process of seeking support from adult social care services? (Tick all that apply)*

I am looking into the different options for careI am in the process of having a care needs assessmentI am looking into the cost of careI am in the process of having a financial assessmentI have had a financial assessmentOther
Location

Knowing your location helps us organise user research activities that are convenient for participants.
Where are you willing to take part in research? (Tick all that apply)

Online sessions (you'll participate in a remote online session)Visit our office (you'll come to a council building in the borough)Have us visit you (a researcher will visit you at home or work)
Visit our office
You'll be asked to visit our council office to try new online services and talk to researchers about how you've used council services in the past. These sessions usually last an hour.

Have us visit you
Researchers will visit you at home or at work to ask you questions about how you use council services. These sessions can vary in duration but usually last less than 2 hours.

Online sessions
During online sessions you'll need to use your own computer, tablet or phone. You can conduct the session anywhere with an internet connection. The sessions usually last an hour.
How did you hear about this sign up form?

Kingston.gov.ukKingston Carer's networkEmail from Kingston Research TeamStaywellOther
Please verify that you are human*
Should be Empty:

Join our research panel and help shape improvements to Kingston Council's Adult Social Care services

Data Privacy

Unfortunately you do not meet the criteria for our research. We cannot add you to the register if you work for Kingston or Sutton council.

About you

Accessing the internet

Accessibility

Experience with adult social care

Location