Please tell us your age
*
Under 60
60 - 79
80 and Over
Please select your country
*
England
Scotland
Wales
Which company supplies your gas?
*
British Gas or Scottish Gas
EDF Energy
Scottish Power
Scottish and Southern Energy
E.ON
npower
Don't have mains gas
SWALEC
Scottish Hydro Electric
EBICo
Seeboard
Staywarm
Southern Electric
Utilita
Other/ Don’t Know
Atlantic Electric and Gas
Telecom Plus
Spark Energy
Good Energy
Green Energy
First Utility
Ecotricity
Which company supplies your electricity?
*
British Gas or Scottish Gas
EDF Energy
Scottish Power
Scottish and Southern Energy
E.ON
npower
Atlantic Electric and Gas
SWALEC
Scottish Hydro Electric
EBICo
Seeboard
Staywarm
Southern Electric
Utilita
Other/ Don’t Know
Telecom Plus
Spark Energy
Good Energy
Green Energy
First Utility
Ecotricity
*What is your housing status?
*
Own your home
Rent it privately
Local Authority rented
Housing Association or RSL Rented
Are you or anyone who permanently lives with you?
Pregnant
Caring for one or more children
Neither
Please give the age of the youngest child who lives with you?
(include children who live with you on a permanent or part time basis)
Under 5
5 to 15
16 and over
Are any of the children who live with you disabled?
No
Yes
If you are caring for children, are you?
Single Parent/ Guardian
Living with partner/spouse
Are you disabled or living with a long term illness?
Disabled
Living with a long term illness
Are you in debt on either gas or electricity?
Yes
No
How do you pay for your gas?
Pay quarterly
Direct debt
Prepayment meter
Other
How do you pay for your electricity?
Pay quarterly
Direct debt
Prepayment meter
Other
What is your annual household income?
Less than £15,050
More than £15,050
Do you manage you energy bills online?
Yes
No
What benefits are you claiming? (tick all that apply)
Income-based Job Seekers Allowance
Income Support
Income Support Disability premium
Income Support Severe Disability premium
Income Support Pensioner Premium
Income Support Disabled Child Premium
Council Tax Benefit
Council Tax Benefit Disability Premium
Housing Benefit
Housing Benefit Disability Premium
Pension Credit Guarantee Element
Pension Credit Savings Element
Working Tax Credit
Working Tax Credit Disability Element
Disability Living Allowance
Disabled Person Tax Credit
Disablement Pension Benefit
War Disablement Pension (plus constant attendance allowance or mobility supplement)
Industrial Injuries Disablement Benefit (plus constant attendance allowance)
Attendance Allowance
Child Tax Credit
Child Tax Credit Disabled Child Element
DWP website provides more information on each of the benefits listed above