This questionnaire is completely confidential and for the use of LYSIS/LIS only.

The purpose is to help us to make sure that what we are offering young lesbians is what you need, to improve the service and to help us get better support for young lesbians.

Date:           Age:

First Name:        

Where did you get our number/address?  

Please state which county you live in:        

Is where you live (please tick):



Small town

Large town


Are you a religious person? Yes/no.

If yes, what religion?


Have you spoken to anyone about being lesbian? Yes/no.

If yes, who and what happened?

Do your parents know? Yes/no.

If yes, what happened?

If no, do you have any idea what your parents might think about homosexuality?

Have you told anyone at school/college/work? Yes/no.

If yes, what was their response?

How old were you when you first thought you were 'different' (you may not have called yourself lesbian/gay)?

What have you read about being lesbian?

Is there a local lesbian/gay helpline or support group? Yes/no.

If yes, have you tried to contact them and what happened?

Do you know any lesbians/gays? Yes/no.

LYSIS provides a whole range of support. This includes:


If you are happy to receive information through the post (in a plain brown envelope) we send out a free copy of a booklet called "i think i might be a lesbian ... now what do i do?" which was written by a group of young lesbians in the U.S.A. but adapted with their permission. Once you have read the booklet you can tell us what you think about it and/or come back to us with any further questions

Booklet sent? Yes/no

comments - useful?

Pack sent? Yes/no

comments - useful?

Book sent? yes/no

comments - useful?

Video sent? yes/no

comments - useful?

Special material sent (e.g. Asian young lesbians)? yes/no

comments - useful?


Pen-pal? yes/no

comments - useful?

Referral? yes/no

who referred to?

comments - useful?


On-going letters?

On-going telephone counselling?

Comments - useful?


What are the issues raised? How deal with?


How far on has the person moved, i.e. what read, who met, who out to, how feel about being lesbian?


Have you found it helpful to be in contact with LYSIS? yes/no

If yes/no in what ways?

Would you say the service LYSIS provides is:

excellent, very good, good, not bad, poor.

Are you pleased to use LYSIS?

If yes/no in what ways?

Were you able to communicate with LYSIS? yes/no?

If yes/no in what ways?

Were they able to deal with your questions? yes/no

If yes/no in what ways?

Did you find their response satisfactory? yes/no

If yes/no in what ways?

Did you fell less distressed having been in contact with LYSIS? yes/no

If yes/no in what ways?

Have you any other comments on the service LYSIS provides?