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Customer Focus Group
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Customer Focus Group

Customer Focus Group

1.

Please tell us your full name *

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2.

Please provide an email address that we use to contact you *

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Maximum 255 characters

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3.

Please tell us your mobile number. If you do not have a mobile number, please provide us with your home phone number *

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Maximum 255 characters

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4.

What is the gender you identify with *

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Male

Female

Non-binary

Prefer not to say

5.

Do you consider yourself to have a disabilty *

* required

Yes

No

Prefer not to say

6.

Please select your age group *

* required

0-17

18-29

30-49

50-74

75+

7.

Where do you live *

* required

Hemel Hempstead

Berkhamsted

Tring

Kings Langley

Outside of Dacorum

Another village/town in Dacorum

8.

Privacy Policy *

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Please tick to confirm that you have read and understood Dacorum Borough Council's Privacy Policy

9.

Have you recently used one of our services, if yes please tell us below *

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Maximum 20,000 characters

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10.

*

As part of our transformation journey, we would like to continue to engage with our Customers. If this is something that you are interested in and are happy for us to contact you in the future about more opportunities to get involved, please confirm below.

* required

Yes

No

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