Getting to know you…

Welcome to The Club

We would like to know a little more about you so we can improve and tailor our services for our users.

Consent*
We are committed to protecting your data and any information you share will be kept private, confidential and anonymous. If you would like to see our data protection policies, you can view them online at www.moveitorloseitclub.co.uk. Please indicate your consent to share this information with us by ticking the box below:
I consent to provide Move it or Lose it with the required information.
About you
We would like to know a little more about you so we can improve and tailor our services for our users
Please tell us your name:
Please tell us your email address:*
Please tell us your age:*
- 50 or under
- 51 to 60
- 61 to 70
- 71 to 80
- 81 to 90
- 90 and over
Please tell us your gender that you identify with:*
- Male
- Female
- Prefer not to say
Please tell us your ethnicity that you identify with:*
- White
- Mixed / Multiple ethnic groups
- Asian / Asian British
- Black / African / Caribbean / Black British
- Other ethnic group
- Prefer not to say
White including: English / Welsh / Scottish / Northern Irish / British, Irish, Gypsy or Irish Traveller, Any other White background. Mixed / Multiple ethnic groups including: White and Black Caribbean, White and Black African, White and Asian, Any other Mixed / Multiple ethnic background. Asian / Asian British including: Indian, Pakistani, Bangladeshi, Chinese, Any other Asian background. Black / African / Caribbean / Black British including: African, Caribbean, Any other Black / African / Caribbean background. Other ethnic group including: Arab, Any other ethnic group.
Are you a new or existing user of The Club?*
If you have not accessed any of The Club's content, select 'New user'. If have you previously used the Video Club, select 'Existing user'.
- New user
- Existing user
How did you hear about The Club?
Please tell us the postcode in which you live:
Do you live alone?
- Yes
- No
How many people do you live with in each age group?
Under each age group, type the number of people you live with in that age group. In none, leave blank.
0 to 15 years 16 to 30 years 31 to 45 years 46 to 60 years 61 to 75 years 76 to 90 years 90 years and over
What is your profession?
Please state the nature of your profession. If you are retired, what did you do for work? If you have not had a profession please write 'n/a'.
Industry worked in? Job title?
Do you have health conditions that impact on your daily living?*
For example, sight or hearing loss, a heart condition or disease e.g cancer
- Yes
- No
- Prefer not to say
If yes, due to these health conditions have you had difficulty partaking in physical activities which you would like to do?
For example: sport (golf), exercise (walk in the park), activity related to work or leisure.
- Never
- Occasionally
- Sometimes
- Often
- Always
If you are happy to, please tell us the health condition/s you have:
Do you require any help or support to complete day to day living activities?
- No, I am able to do all activities myself
- Yes, but only very occasionally and do most of my activities by myself
- Yes, I sometimes require help to complete the more complex tasks
- Yes, I often require someone to help me day to day
- Yes, I am dependent on others helping me to complete daily activities
Physical Activity
We’d like to understand a bit more about how active you are now and how active you have been in the past. Please answer the following questions as accurately as you can, but don’t worry if it’s not exact.
How much time did you spend exercising during your teenage years?
For example, playing sport or moderate to high intensity physical activity.
- Less than 1 hour per week
- About 1 hour per week
- 2 to 3 hours per week
- 4 to 5 hours per week
- More than 5 hours per week
How much time did you spend exercising during your 30s?
For example, playing sport or moderate to high intensity physical activity.
- Less than 1 hour per week
- About 1 hour per week
- 2 to 3 hours per week
- 4 to 5 hours per week
- More than 5 hours per week
How much time did you spend exercising during your 50s?
For example, playing sport or moderate to high intensity physical activity.
- Less than 1 hour per week
- About 1 hour per week
- 2 to 3 hours per week
- 4 to 5 hours per week
- More than 5 hours per week
- n/a
How much time did you spend exercising in the last year?
For example, playing sport or moderate to high intensity physical activity.
- Less than 1 hour per week
- About 1 hour per week
- 2 to 3 hours per week
- 4 to 5 hours per week
- More than 5 hours per week
Use of The Club
We'd like to know a bit more about what brought you to The Club to help us improve the service.
What part(s) of The Club are you intending to use?*
(select all that apply)
- The Live Broadcasts
- The Exercise Club
- The Social Club
How do you think The Club will benefit you?
Did the COVID-19 pandemic influence your decision to subscribe to this service?*
- Yes
- No
If yes, please provide more detail
Social engagement
How often do you feel you lack companionship?
- Hardly ever
- Some of the time
- Often
How often do you feel left out?
- Hardly ever
- Some of the time
- Often
How often do you feel isolated from others?
- Hardly ever
- Some of the time
- Often
Security

Thank you for taking the time to complete the survey.

0 to 15 years	16 to 30 years	31 to 45 years	46 to 60 years	61 to 75 years	76 to 90 years	90 years and over

Industry worked in?	Job title?

Getting to know you…

Welcome to The Club

About you

Physical Activity

Use of The Club

Social engagement