Port In The Storm Survey

Port In The Storm Survey

We may use some of your answers for training, business development and marketing purposes but this will always be done anonymously, even if you’ve shared your name with us. You can complete this form anonymously or, if you’re happy to include your name and email address, we will add you to our mailing list to receive our monthly newsletter.
Please read the information below to give some context to the questions asked:

Port In The Storm (PITS for short) is a new practical support service designed to help people who are dealing with a life challenge. By ‘life challenge’, we mean anything that makes life more difficult than usual, that you would like to resolve or move forward in – at PITS, we call these ‘life storms’. This can be anything from a complaint to something more life changing like redundancy or a bereavement. Whilst many free services, like Citizens Advice and other charities, struggle to fund free support and often need to limit their offering to generic advice, Port In The Storm is a new way to get the personalised support you need, when you need it.

Please be aware that this survey asks about challenging experiences you have encountered in life, so may trigger any associated emotions. Whilst we would like you to be honest about your experiences, to help us understand what people need in these difficult situations, please only include information you are happy to share.
Referral name
If referred by a friend, otherwise leave blank

1. What ‘life challenges’ have you faced in the last five years?*
2. How did you deal with these challenges?*
3. Thinking about your answer to question 2, if the same challenge(s) happened to you again, would you deal with it in the same way? If not, why not?*

4. Are you aware of any other support services similar to Port In The Storm and have you ever used them? If so, what did you like or dislike about them?*
5. In the future, if you were to use a support service like Port In The Storm, what support would you want or expect?*
6. What features or aspects of a support service would be most important to you? *

To help us better understand our potential customers, please complete the demographic questions, below:
a. What gender do you identify as?*

Prefer not to sayMaleFemaleOther
b. How old are you?*
c. Where do you live?*
d. What is your gross annual household income?*
We need to know this so that we can identify how affordable our service may be to you.
e. How is this income made up? (please tick all relevant boxes)*

EmploymentSelf-employmentBenefitsPensionOther

If you would like to receive our monthly newsletter, please provide your name and email address.

By providing your name and email address you agree to receive our monthly newsletter which you can, of course, unsubscribe from at any time.
Name

First NameLast Name
Email
example@example.com
Should be Empty: