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    LIVED EXPERIENCE PARTICIPANT

    Participant Information

    First Name

    Last Name

    Gender

    Date of Birth

    Mobile Number

    WELLBEING FORM

    We are asking you these questions to help us understand how you're feeling at the moment, and whether it's in your interests to participate in the project.

    Below are some statements about feelings and thoughts.

    Please select from the dropdown that best describes your experience of each over the last 2 weeks.

    I’ve been feeling optimistic about the future:

    I’ve been feeling useful:

    I’ve been feeling relaxed:

    I’ve been feeling interested in other people:

    I’ve had energy to spare:

    I’ve been dealing with problems well:

    I’ve been thinking clearly:

    I’ve been feeling good about myself:

    I’ve been feeling close to other people:

    I’ve been feeling confident:

    I’ve been able to make up my own mind about things:

    I’ve been feeling loved:

    I’ve been interested in new things:

    I’ve been feeling cheerful:

    PROJECT EVALUATION FORM

    We are asking you these questions to help us understand how we performed during this project and how this has impacted you.

    Below are some statements about how the project went. How much do you agree/disagree with the following statements (where 1 = Disagree Strongly and 10 = Agree Strongly).

    Please select from the dropdown that best describes your experience of the Digital Lived Experience Project.

    a) The check-in/onboarding process for project was good and I was well informed about the process

    b) Sharing my mental health story was a positive experience

    c) I enjoyed the process of talking about my mental health and making the video

    d) It has made me feel better about myself and my mental health

    e) I felt safe through the experience

    f) The thought that my story will help others makes me feel good

    g) I'm proud of video we produced

    Below are some questions about how the project affected you.

    Please write down what best describes your experience of the Digital Lived Experience Project.




    g) 6. How likely would you be to take part in a similar project in the future, where 1 = Very unlikely and 10 = Very likely

    Data Protection

    By submitting this form I consent for SAFA Cumbria to read and review the data that I have submitted, to store it for as long as necessary to process my application, and to contact me about it.


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    * by submitting this form you are consenting to providing the data outlined above.

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