Parent or Carer

All fields are mandatory

First Name

Surname

Date of Birth

Postcode

Phone Number

Password

Must include the following:

10 characters 1 upper character 1 lowercase character 1 special character 1 number non-repeating characters

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How many children do you have?

First child's name

First child's dob

Second child's name

Second child's dob

Third child's name

Third child's dob

Fourth child's name

Fourth child's dob

Fifth child's name

Fifth child's dob

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Healthy Lifestyles

Healthy Lifestyles Questionnaire

Thank you for taking the time to complete the Healthy Lifestyle Questionnaire below. Your answers will help us learn more and improve our service.

What information would your child like to know more about?

Eating Habits & Portion Sizes Exercise/Activities Screen Time Food Labels Sleep Healthy Bowels & Healthy Bladder

What is the most useful way for your child to get this information?

Webinar

Website

Schools Groups

Community Groups/Clubs

Assemblies

Classroom

Do you use the following websites for support?

Just One Norfolk FYI Norfolk Neither Other

If you haven't visited either website, you can find links to the healthy lifestyle pages and other information about the Healthy Child Service below:

Just One Norfolk

FYI Norfolk

You can find more information on healthy lifestyles for young people aged 11-24 on FYI Norfolk.

FYI Norfolk

You can find more information about healthy lifestyles for the whole family on Just One Norfolk.

Just One Norfolk

Please give more information:

Get Involved! We run regular service user engagement events and focus groups to help improve our services, if you are happy to be contacted about these and other opportunities to get involved, please provide your details below:

Full name:

Email Address:

Phone Number:

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