Thames Water Customers

Click to select Ethnic OriginWhite BritishWhite EuropeanBlack CaribbeanBlack AfricanBlack OtherIndianPakistaniBangladeshiChineseOther

Have you taken part in any market research discussion before?

YesNo

How many market research discussions have you taken part in, in the past 6 months and in the past 12 months?

What subjects were researched?

Do you consent to the focus group being audio recorded (this will be used for internal analysis only and your responses will remain anonymous)?

YesNo

Which of the following best describes your family status?

I have a child/ children aged under 16 living with me at homeI do not have any children aged under 16 living with me at home

Which of the following best describes your marital status?

SingleMarriedDivorcedOther

Could you confirm your water supplier?

Thames WaterAnyone else

Could you confirm your wastewater services supplier?

Thames WaterAnyone else

Who in your household is responsible for paying bills (e.g. energy bill, water bill, internet bill)?

Joint or sole responsibilitySpouse/partnerParent/relativeAnyone else

Which of the following best reflects your current employment status?

Working full-timeWorking part-timeStudentUnemployedHousewife-husbandRetired

Do you currently work in or have you ever worked in any of the following sectors/industries?

Utilities (including water)Market ResearchMarketingAdvertisingJournalismMediaNone of the above

Which of the following best describes your annual household income?

£16,105 or lessMore than £16,105

Which of the following best describes your housing situation?

I rent my home from the council or housing association, etcI rent my home from a private landlordI own my home with a mortgageI own my home outright (without a mortgage)Other (please specify)

How many generations of the same family currently live in your household?

123+Don’t know

How many people live in your household?

1-23-456+

What is the approximate cost of your annual household water and wastewater bill from Thames Water?

£0-£100£101-£200£201-£300£301-£400£401-£500£501-£600£600+

Do you have a long term illness, health problem or impairment that limits your daily activities?

YesNo

Which of the following best describes how your impairment or illness affects you? (Please select all that apply)

Vision (blindness or visual impairment)Hearing (deafness or hard of hearing)Physical (wheelchair user, mobility issues, amputee, dwarfism)Learning or concentrating or remembering difficultiesMental health problemsSocial or behavioural issues (e.g. due to neurological diverse conditions such as Autism, Attention Deficit or Aspergers’ Syndrome)I suffer from a long term health condition, that doesn’t fit any of the aboveDon’t KnowPrefer not to sayNone

Which of the following best describe the physical impairment you have (Please select all that apply):

Manual wheelchair userElectric wheelchair/powerchair userMobility issues due to imbalance or coordinationMobility issues due to illness or painLower limb amputee/congenital limb lossUpper limb amputee/congenital limb lossDwarfismLong term painOthern/a

Which long term health condition do you have?

Hypertension (high blood pressure)Cardiovascular diseaseMusculoskeletalDiabetesChronic kidney diseaseCancerStrokeEpilepsyMuscular DystrophyCystic FibrosisArthritis or rheumatismChronic Pulmonary Disease (COPD)HypothyroidismParalysisMultiple Sclerosis (MS)Cerebral PalsyDementiaOther (please specify)n/a

Which of the following statements best applies to you?

My health problem(s) impact my day-to-day significantlyMy health problem(s) somewhat impacts my day-to-day lifeMy health problem(s) impacts my day-to-day life very littleMy health problem(s) doesn’t affect my day-to-day life at alln/a

Thinking about your water bill specifically, what method do you use to pay?

Direct debitCash/cheque/other method

How do you receive your water bill?

From Thames Water directlyFrom another group (e.g. local authority, landlord)

Do you have a water meter?

YesNo

We will be conducting more research on behalf of Thames Water later this year, would you be interested in us contacting you later about completing online research?

YesNo

Date and time you'd like to be interviewed?

Alternative date and time, in case first choice is not possible?