Jigsaw Link Members

Annual Evaluation2015

1.Has Jigsaw Link improved your social life?

Not at all0 246810 Hugely N/A

2. Has Jigsaw Link enabled you to make new friends?

Not at all0 2 46810 Hugely N/A

3.Do you feel more supported since joining Jigsaw Link?

Not at all0 2 46810 Totally N/A

4.Do you find the Jigsaw Link newsletter informative?

Not at all0 2 46810 Hugely N/A

5. Has attending Jigsaw Link programmes helped you feel physically healthier?

Not at all0 24 68 10 Hugely N/A

6. Has attending Jigsaw Link programmes helped improve yourmentalhealth*?

(Please see note below for a description of mental health)

Not at all0 24 68 10 Hugely N/A

7. What do you think works well in the Jigsaw Link service and what do you think could

be improved?

8. Has participating in Jigsaw Link activitiesincreased your self-esteem?

Not at all0 24 6 8 10 Hugely N/A

9. What Jigsaw Link services or activities do you participate in?

BefrienderOutingsLunch ClubsTelephone Befriending

Newsletter only 

10. How was your confidencebefore your participation?

No confidence0 2 46810Very confident N/A

11.How is your confidenceafteryour participation?

No confidence 0 2 4 6 8 10Very confident N/A

12. How lonely did you feel before joining Jigsaw Link?

Lonely0 2 46810Not lonely N/A

13. How lonely do you feel afteryour involvement with Jigsaw Link?

Lonely0 2 46810Not lonely N/A

14. How active as an older person were youbefore joining Jigsaw Link?

Not at all0 2 46810Hugely N/A

15. How active as an older person are you since joining Jigsaw Link?

Not at all0 2 46810Hugely N/A

16. How would you describe your mood before joining Jigsaw Link?

Unhappy0 2 46810Very happy N/A

17. How would you describe your mood after joining Jigsaw Link?

Unhappy0 2 46810Very happy N/A

Additional comments

Name ………………………………..………………….Thank you for your feedback.

Notes

*Mental health is defined as a state of well-being in which every individual realizes his or her own

potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to

make a contribution to her or his community

Monitoring Form

Ethnic background

White
English/Scottish/Welsh/Northern Irish/UK
Irish
Gypsy or Irish Traveller
Any other White background
Mixed ethnic background
Asian/Asian UK
Indian
Pakistani
Bangladeshi
Chinese
Any other Asian background
Black/African/Caribbean/Black UK
African
Caribbean
Any other Black/African/Caribbean background
Other ethnic group
Arab
Any other ethnic group

Gender

Please Tick / Male
Female
Prefer not to say

Age

Please Tick / 0-24 years
25-64 years
65+ years

Disability

Do you consider yourself to have a disability?
No
Yes
Prefer not to say

Religion or belief

Tick one box only below

No religion
Christian
Buddhist
Hindu
Jewish
Muslim
Sikh
Other religion
Prefer not to say

Sexual orientation

Heterosexual
Lesbian, gay man, bisexual
Prefer not to say