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[null,null,null,null,null,null,null,null,null,null,"v5"]
[]
[null,"Reducing Parental Conflict Programme"]
[null,"Referral Stage Questionnaire "]
[null,"For parents expecting their first child who are  no longer in a relationship "]
[null,"together/separated"]
[]
[null,"Please read the following instructions."]
[]
[null,"Please could you answer all questions in Part 1 asking for information relating to you ",null,null,null,null,null,null,null,null,null,"Values"]
[null,"and your family."]
[]
[null,"Once you have provided your information please move on to Part 2. Please answer "]
[null,"all questions in this section."]
[]
[null,"Once completed please return the questionnaire to the person who gave it to "]
[null,"you."]
[]
[null,"Additional Needs (including any needs for interpreters etc.)"]
[]
[null,"I have no additional needs that might make it difficult for me to take part"]
[]
[null,"I have additional needs that might make it difficult for me to take part. "]
[null,"I have given details of these below:"]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L25=1, \"No Additional Needs Identified\", IF(L25=2, \"Additional Needs Identified\", \"Must Complete\"))","v":"Must Complete"}]
[null,"Please give details"]
[]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(B27>0, B27, \"Additional Needs not entered\")","v":"Additional Needs not entered"},{"$f":"IF(B27>0, \"Additional Needs Entered\", \"Additional Needs not entered\")","v":"Additional Needs not entered"}]
[]
[null,"I have completed a separate Participation Agreement with the person who gave me the "]
[null,"questionnaire",null,null,null,null,null,null,null,null,null,false,{"$f":"IF(L31=TRUE, \"Participation Agreement Completed\", \"Must Complete\")","v":"Must Complete"}]
[]
[null,"If you are completing a paper copy of this questionnaire, please select just one answer "]
[null,"for multiple choice questions."]
[]
[null,"Is anyone within your household currently in work?"]
[null,"Yes"]
[null,"No",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L38=1, \"Yes\", IF(L38=2, \"No\", \"Must Complete\"))","v":"Must Complete"}]
[]
[]
[]
[]
[]
[null,"PART 1"]
[]
[null,"Parent information"]
[]
[null,"This section collects important information about you and your family."]
[null,"Please complete all questions in this section."]
[]
[null,"About You"]
[]
[null,null,null,"Please complete below"]
[null,"Title",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D54>0, D54,\"Must Complete\")","v":"Must Complete"}]
[null,"Forenames",null,null,null,null,null,null,null,null,null,null,"Must Complete"]
[null,"Surname",null,null,null,null,null,null,null,null,null,null,"Must Complete"]
[null,"Date of birth\n(dd/mm/yyyy)",null,null,null,null,null,null,null,null,null,null,"Must Complete"]
[null,"Telephone\nnumber (mobile)",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D58>0, \"+44 \"&D58,\"Must Complete\")","v":"Must Complete"}]
[null,"Alternative\ntelephone \nnumber (e.g. landline)",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D59>0,\"+44 \"& D59,\"No alternative number supplied\")","v":"No alternative number supplied"}]
[null,"Address",null,null,null,null,null,null,null,null,null,null,"Must Complete"]
[null,"Post code",null,null,null,null,null,null,null,null,null,null,"Must Complete"]
[null,"Email",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D62>0, D62, \"No email address supplied\")","v":"No email address supplied"}]
[]
[null,"What is your gender identity? Please select below."]
[]
[]
[null,"Male"]
[null,"Female"]
[null,"Other"]
[null,"Prefer not to say",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L70=0,\"Must Complete\",IF(L70=1,\"Prefer not to say\",IF(L70=2,\"Other\",IF(L70=3,\"Female\",IF(L70=4,\"Male\",\"INCORRECT\")))))","v":"Must Complete"}]
[]
[null,"Disability:"]
[null,"Do you have a long-standing physical or mental impairment, illness or disability? By "]
[null,"long-standing' we mean anything that has troubled you over a period of at least 12 "]
[null,"months or that is likely to trouble you over a period of at least 12 months."]
[]
[]
[null,"Yes",null,"No ",null,"Prefer not to say",null,null,null,null,null,0,{"$f":"IF(L78=0, \"Must Complete\", IF(L78=1, \"Prefer not to say\", IF(L78=2, \"No\", IF(L78=3, \"Yes\",\"Incorrect\"))))","v":"Must Complete"}]
[]
[]
[]
[null,"What is your ethnic group? Select one option that best describes your ethnic group "]
[null,"or background."]
[]
[null,"White"]
[null,"    1.  English/Welsh/Scottish/Northern Irish/British"]
[null,"    2.  Irish"]
[null,"    3.  Gypsy or Irish Traveller"]
[null,"    4.  Any other white background. Please describe below:"]
[]
[null,"Mixed/ Multiple Ethnic Groups"]
[null,"    5.  White and Black Caribbean"]
[null,"    6.  White and Black African"]
[null,"    7.  White and Asian"]
[null,"    8.  Any other Mixed/Multiple ethnic background. Please \n         describe below:"]
[]
[null,"Asian/Asian British"]
[null,"    9.  Indian"]
[null,"    10. Pakistani"]
[null,"    11. Bangladeshi"]
[null,"    12. Chinese"]
[null,"    13. Any other Asian background. Please describe below:"]
[]
[null,"Black/African/Caribbean/Black British "]
[null,"    14. African"]
[null,"    15.  Caribbean"]
[null,"    16. Any other Black/African/Caribbean background. Please describe below:"]
[]
[null,"Other ethnic group "]
[null,"    17. Arab"]
[null,"    18. Any other ethnic group. Please describe below:"]
[null,null,null,null,null,null,null,null,null,null,null,0]
[null,"    19. Prefer not to say",null,null,null,null,null,null,null,null,null,{"$f":"IF(L112=4, B90, IF(L112=8, B96, IF(L112=13,B103,  IF(L112=16, B108, IF(L112=18, B112, \"None Selected\")))))","v":"None Selected"}]
[null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(L112>0,L112,\"Must Complete\")","v":"Must Complete"},{"$f":"IF(L112=0, \"None Selected\", IF(L113=\"None Selected\", \"Standard Ethnicity Type\",  IF(L113=0, \"Please Select/Enter Type\",L113)))","v":"None Selected"}]
[]
[]
[null,"Please answer the following questions by selecting your answer."]
[]
[null,"What is your marital status?"]
[]
[null,"Single (never married or been in a civil partnership)"]
[null,"Married or in a Civil Partnership and living with husband/wife"]
[null,"Living together"]
[null,"Steady relationship without living together "]
[null,"Separated"]
[null,"Divorced"]
[null,"Widowed"]
[null,"Prefer not to say"]
[null,"Other",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L129=1,\"Single\",IF(L129=2,\"Married or Civil Partnership\",IF(L129=3,\"Living Together\",IF(L129=4,\"Steady Relationship\",IF(L129=5,\"Separated\",IF(L129=6,\"Divorced\",IF(L129=7,\"Widowed\", IF(L129=8, \"Prefer not to say\", IF(L129=9, \"Other\", \"Must Complete\")))))))))","v":"Must Complete"}]
[]
[null,"How many children do you have primary or shared care responsibility for?"]
[]
[null,"Expecting first child"]
[null,1]
[null,2]
[null,3]
[null,"4 or more"]
[null,"None",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L138=1,\"Expecting first child\",IF(L138=2,1,IF(L138=3,2,IF(L138=4,3,IF(L138=5,\"4 or more\",IF(L138=6,\"None\",\"Must Complete\"))))))","v":"Must Complete"}]
[]
[null,"Which of these best describes your current employment status?"]
[]
[null,"Please note: if you are on parental leave, you should tick the box of the category you"]
[null,"were in prior to this leave."]
[]
[null,"Self employed"]
[null,"In full time paid employment"]
[null,"In part time paid employment (less than 30 hours/week)"]
[null,"Unemployed"]
[null,"Retired"]
[null,"Looking after family or home (unpaid)"]
[null,"Full-time student"]
[null,"Long-term sick or disabled"]
[null,"On a government training scheme"]
[null,"Doing something else"]
[null,"Prefer not to say",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L155=1,\"Self employed\",IF(L155=2,\"Full time employment\",IF(L155=3,\"Part time employment\",IF(L155=4,\"Unemployed\",IF(L155=5,\"Retired\",IF(L155=6,\"Looking after family or home\",IF(L155=7,\"Full time student\",IF(L155=8,\"Long term sick/disabled\",(IF(L155=9,\"On a government training scheme\",IF(L155=10,\"Doing something else\",IF(L155=11,\"Prefer not to say\",\"Must Complete\"))))))))))))","v":"Must Complete"}]
[]
[]
[]
[null,"Are you presently or have you ever experienced mental health problems? "]
[]
[null,"No, and I have no mental health diagnosis"]
[null,"No, but I do have a mental health diagnosis"]
[null,"Yes, but I do not have a mental health diagnosis"]
[null,"Yes, and I have a mental health diagnosis"]
[null,"Don't know"]
[null,"Prefer not to say",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L166=1, \"No, No diagnosis\", IF(L166=2, \"No, Have diagnosis\", IF(L166=3, \"Yes, No diagnosis\", IF(L166=4, \"Yes, Have diagnosis\", IF(L166=5, \"Don't know\", IF(L166=6, \"Prefer not to say\", \"Must Complete\"))))))","v":"Must Complete"}]
[]
[]
[null,"What is your relationship with the person you are currently experiencing"]
[null,"conflict with? "]
[]
[null,"Married or in a Civil Partnership"]
[null,"Living together (but not married or in a civil partnership)"]
[null,"Steady relationship without living together"]
[null,"Separated"]
[null,"Divorced"]
[null,"Other"]
[null,"Prefer not to say",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L178=1, \"Married or Civil Partnership\", IF(L178=2, \"Living Together\", IF(L178=3, \"Steady Relationship\", IF(L178=4, \"Separated\", IF(L178=5, \"Divorced\", IF(L178=6, \"Other\", IF(L178=7, \"Prefer not to say\", \"Must Complete\")))))))","v":"Must Complete"}]
[]
[null,"I understand that the provision is most effective when both parents attend together.  I am "]
[null,"supplying the other parent’s details below so that we can be referred to provision together. I "]
[null,"understand that if both parents are unable to attend this provision, then I may not be able to"]
[null,"receive this support as some types are only able to proceed with both parents."]
[]
[null,"Their name",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D185>0, D185,\"Co-Parent details not supplied\")","v":"Co-Parent details not supplied"}]
[]
[null,"Their date of birth",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D187>0, D187, \"Co-Parent details not supplied\")","v":"Co-Parent details not supplied"}]
[null,"(dd/mm/yyyy)"]
[]
[null,"PART 2 - About Your Circumstances"]
[]
[null,"There are two sections of questions in this part of the questionnaire. Please answer "]
[null,"all questions to the best of your ability, even if they do not seem entirely relevant to "]
[null,"you. "]
[]
[null,"Once you have finished these questions, please return the questionnaire to the "]
[null,"person who gave it to you. "]
[]
[]
[null,"Section 1:  Interacting with each other"]
[]
[null,"Considering the last 4 weeks, how often does the following occur between you and"]
[null,"your former (Ex) partner/spouse? Please answer as best as you can, selecting your "]
[null,"response for each question"]
[null,"With those times in mind, please indicate how often your spouse/partner acted in the "]
[null,"following ways towards you. During the past 4 weeks, how often did your "]
[null,"spouse/partner…"]
[]
[null,"1. When you & your former partner/spouse discuss parenting issues, how often does it "]
[null,"lead to an argument?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L214>0, L214, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"2. How often is the atmosphere one of hostility and anger?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L220>0, L220, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"3. How often are your conversations stressful and tense?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L226>0, L226, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"4. Do you and your former partner/spouse have basic differences of opinion"]
[null," about issues related to raising your child / parenting? "]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L233>0, L233, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"5. Is your former partner/spouse helpful to you in raising your child / children?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L239>0, L239, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"6. Would you say that you are helpful to your former partner/spouse in preparations "]
[null,"for raising your child/children?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L246>0, L246, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"7. Do you feel that your former partner/spouse understands and is supportive of your "]
[null,"needs as an expectant parent?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L253>0, L253, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[null,"Section 2:  Conflict between parents"]
[]
[null,"Think back over the last 4 weeks and tell us how well you and your former"]
[null,"spouse /partner  have related in the following ways:"]
[]
[null,"1. How well do you share responsibility in plans for raising your child / children?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L265>0, L265, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"2. How well do you communicate about your unborn child / children?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L271>0, L271, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"3. How often do you agree when making decisions about your unborn child / children?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L277>0, L277, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[null,"We would now like to ask how frequently you and your former spouse/partner argue "]
[null,"about each of the following nine topics:"]
[]
[null,"4. Children"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L287>0, L287-1, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[null,"5. Money"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L294>0, L294-1, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[null,"6. Chores and responsibilities"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L301>0, L301-1, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[null,"7. Showing affection (towards each other)"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L308>0, L308-1, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[null,"8. Religion"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L315>0, L315-1, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[null,"9. Leisure time"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L322>0, L322-1, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[null,"10. Drinking"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L329>0, L329-1, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[null,"11. New partners"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L336>0, L336-1, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[null,"12. Relatives"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L343>0, L343-1, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[]
[]
[null,null,{"$f":"IF(L348>0, \"You have not completed one or more questions, please complete them.\", \"\")","v":"You have not completed one or more questions, please complete them."},null,null,null,null,null,null,null,null,{"$f":"COUNTIF(M31:M353, \"Must Complete\")","v":36}]
[null,null,null,null,null,"END OF QUESTIONS"]
[]
[null,null,null,null,null,"Thank you for completing this questionnaire"]
[]
[]
[]
[]
[null,"For use by staff member"]
[]
[null,"Why is this data being collected?"]
[null,"This information will be really valuable for providers and RPC Local Authorities and "]
[null,"gateways to work effectively with you to support parents on the Programme, as well as for "]
[null,"internal learning within the CPAs on the referral process."]
[]
[null,"The information is also being collected to contribute to DWP’s evaluation of the RPCP. DWP "]
[null,"have contracted two independent research companies to support the evaluation: IFF, and "]
[null,"Tavistock Institute of Human Relations (TIHR) who may contact you to seek your views on "]
[null,"your experiences of the referral process and of identifying and supporting parents in conflict. "]
[null,"The results of the evaluation will be published, though all results will be anonymised, so you "]
[null,"will not be identifiable in any way"]
[]
[null,"What happens to information collected about me?"]
[null,"Your contact details will be shared with the Provider and Local Authority CPA gateway to "]
[null,"help them to work effectively with parents on the Programme, as well as for the CPA Local "]
[null,"Authorities to understand locally the how the RPC Programme is working. "]
[]
[null,"For DWP’s evaluation, your professional contact information will be transferred securely from "]
[null,"DWP to IFF and TIHR who may contact you to take part in further research for the "]
[null,"evaluation of the RPCP. If contacted, you may decline to participate. Although we would "]
[null,"value your feedback on the programme. "]
[]
[null,"You can request a copy of the information DWP holds about you on the link below. "]
[null,"https://www.gov.uk/guidance/request-your-personal-information-from-the-department-for-work-and-pensions"]
[]
[null,"You can also change the information you have provided and or withdraw the information "]
[null,"DWP holds about you."]
[null,"https://www.gov.uk/government/organisations/department-for-work-pensions/about/personal-information-charter#dpo"]
[]
[null,"You can do this by contacting our Data Protection Officer at: "]
[null,"data.protectionofficer@dwp.gsi.gov.uk."]
[]
[null,"The legal basis for processing your data:"]
[null,"DWP have a public function to evaluate and assess their programmes. Data processing will "]
[null,"be carried out under Article 6 of the GDPR which states: the processing is necessary for the "]
[null,"performance of a task carried out in the public interest or in the exercise of official authority "]
[null,"vested in the controller Art 6(1)(e)"]
[]
[null,"How long will the information be kept?"]
[null,"We will only keep your data until the end of the evaluation of the Reducing Parental Conflict "]
[null,"Programme. This is set to end in 2023."]
[]
[null,"By opting to complete this section, you are agreeing to supply your data under the terms "]
[null,"above."]
[]
[null,"Why is this data being collected?"]
[null,"The information you provide below is being collected to contribute to DWP’s evaluation of "]
[null,"the RPCP. DWP have contracted two independent research companies to support the "]
[null,"evaluation: IFF, and Tavistock Institute of Human Relations (TIHR) who may contact you to "]
[null,"seek your views on your experiences of the referral process and of identifying and "]
[null,"supporting parents in conflict. The results of the evaluation will be published, though all "]
[null,"results will be anonymised, so you will not be identifiable in any way."]
[]
[null,"What happens to information collected about me?"]
[null,"Your professional contact information will be transferred securely from DWP to IFF and TIHR "]
[null,"who may contact you to take part in further research for the evaluation of the RPCP. "]
[]
[null,"If contacted, you may decline to participate. Although we would value your feedback on the "]
[null,"programme. "]
[]
[null,"You can request a copy of the information DWP holds about you. You can also change the"]
[null,"information you have provided and or withdraw the information DWP holds about you. You "]
[null,"can do this by contacting our Data Protection Officer at: "]
[]
[null,null,"data.protectionofficer@dwp.gsi.gov.uk"]
[]
[null,"The legal basis for processing your data:"]
[null,"DWP have a public function to evaluate and assess their programmes. Data processing will "]
[null,"be carried out under Article 6 of the GDPR which states: the processing is necessary for the "]
[null,"performance of a task carried out in the public interest or in the exercise of official authority "]
[null,"vested in the controller Art 6(1)(e)"]
[]
[null,"How long will the information be kept?"]
[null,"We will only keep your data until the end of the evaluation of the Reducing "]
[null,"Parental Conflict Programme. This is set to end in 2023."]
[]
[null,"By opting to complete this section, you are agreeing to supply your data under the terms "]
[null,"above."]
[]
[null,"Your Name :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D437>0, D437, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Job Title :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D439>0, D439, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Team :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D441>0, D441, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Service :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D443>0, D443, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Organisation",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D445>0, D445, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Email :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D447>0, D447, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Phone Number :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D449>0, \"+44 \"&D449, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Date Completed :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D451>0, D451, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Local Authority :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D453>0, D453, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Have you had any of the following training / awareness sessions?"]
[]
[null,"Process Training  / Awareness Overview"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L460=1,\"More than 2 Months ago\",IF(L460=2,\"Up to 3 months ago\",IF(L460=3,\"Not received\",\"Please complete\")))","v":"Please complete"}]
[null,"Practitioner Training supplied by DWP/ Knowledgepool (Online)"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L464=1,\"More than 2 Months ago\",IF(L464=2,\"Up to 3 months ago\",IF(L464=3,\"Not received\",\"Please complete\")))","v":"Please complete"}]
[null,"Practitioner Training supplied by DWP/ Knowledgepool (Classroom Based)"]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L467=1,\"More than 2 Months ago\",IF(L467=2,\"Up to 3 months ago\",IF(L467=3,\"Not received\",\"Please complete\")))","v":"Please complete"}]
[]
[]
[null,"Other (Please Specify)",null,null,null,null,null,null,null,null,null,{"$f":"E470","v":0},{"$f":"IF(L470>0, L470, \"Other Training not specified\")","v":"Other Training not specified"}]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L473=1,\"More than 2 Months ago\",IF(L473=2,\"Up to 3 months ago\",IF(L473=3,\"Not received\",\"Please complete\")))","v":"Please complete"}]
[]
[]
[null,"Are the family already being supported by any of the following? "]
[]
[null,"No support"]
[null,"Children's Social Care"]
[null,"Early Help"]
[null,"Other (Please specify below)",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L481>0, L481, \"Must Complete\")","v":"Must Complete"}]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(B482>0, B482, \"No other help entered\")","v":"No other help entered"}]
[null,"Additional Information / Risk Assessment Details"]
[null,"Please give details"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(B486>0, B486, 0)","v":0},{"$f":"IF(L486>0, L486, \"Additional Information not entered\")","v":"Additional Information not entered"}]
[]
[null,null,{"$f":"IF(L348>0, \"One or more questions are incomplete, please complete them.\", \"\")","v":"One or more questions are incomplete, please complete them."},null,null,null,null,null,null,null,null,{"$f":"COUNTIF(M356:M481, \"Must Complete\")","v":10}]

{"sheet":"Admin","index":1,"n_rows":18,"n_cols":10,"rows_kept":18,"cut":false,"hidden":false,"merged":[]}
[]
["***** FOR ADMINISTRATION USE ONLY ******"]
[]
["CPA Email","rpcgateway@gateshead.gov.uk"]
[]
["DWP Email","RPC.REFERRALTEAM@DWP.GOV.UK"]
[]
["Provider Email","RPC@relate.org.uk"]
[]
[]
[]
[]
[]
[null,"Level Calculated"]
[null,{"$f":"IF(Questionnaire!L31=TRUE, Scoring!H41, \"Participation Statement not Completed DO NOT FORWARD\")","v":"Participation Statement not Completed DO NOT FORWARD"}]
[]
[]
[null,{"$f":"CPA!I10","v":"TEST"},null,null,null,null,null,null,null,{"$f":"CPA!I10","v":"TEST"}]

{"sheet":"CPA","index":2,"n_rows":13,"n_cols":15,"rows_kept":13,"cut":false,"hidden":true,"merged":[]}
[]
[" Tab for CPA Admin Use Only"]
[]
[]
["Date RSQ Completed","Parent Name","Date of Birth","Phone Number","Practitioner","Role","Team","Service","Organisation","Email","Phone","LA","Workless Household","Support Level","Main Carer"]
[{"$f":"Questionnaire!M451","v":"Must Complete"},{"$f":"Questionnaire!M54&\" \"&Questionnaire!M55&\" \"&Questionnaire!M56","v":"Must Complete Must Complete Must Complete"},{"$f":"Questionnaire!M57","v":"Must Complete"},{"$f":"Questionnaire!M58","v":"Must Complete"},{"$f":"Questionnaire!M437","v":"Must Complete"},{"$f":"Questionnaire!M439","v":"Must Complete"},{"$f":"Questionnaire!M441","v":"Must Complete"},{"$f":"Questionnaire!M443","v":"Must Complete"},{"$f":"Questionnaire!M445","v":"Must Complete"},{"$f":"Questionnaire!M447","v":"Must Complete"},{"$f":"Questionnaire!M449","v":"Must Complete"},{"$f":"Questionnaire!M453","v":"Must Complete"},{"$f":"IF(Questionnaire!M38=\"Yes\", \"No\", IF(Questionnaire!M38=\"No\", \"Yes\", \"Not Completed\"))","v":"Not Completed"},{"$f":"Admin!B15","v":"Participation Statement not Completed DO NOT FORWARD"},"N/A"]
[]
[null,"Linked Co-Parent",null,null,null,null,null,null,"Enter UIN Below"]
[null,{"$f":"Questionnaire!M185","v":"Co-Parent details not supplied"},{"$f":"Questionnaire!M187","v":"Co-Parent details not supplied"}]
[null,null,null,null,null,null,null,null,"TEST",null,"*Copy and paste yellow cell data to UIN spreadsheet "]
[null,null,null,null," Use this button  to send the full RSQ to DWP",null,null,null,null,null,"to assign a UIN"]
[]
[null,null,null,null," Use this button to send RSQ data to the Provider",null,null,null,"TEST2"]

{"sheet":"DWP","index":3,"n_rows":211,"n_cols":10,"rows_kept":211,"cut":false,"hidden":true,"merged":[[209,1,209,5],[210,1,210,5],[211,1,211,5],[192,3,192,8],[194,3,194,8],[207,1,207,5],[208,1,208,5],[202,2,202,5],[180,3,180,8],[182,3,182,8],[186,3,186,8],[188,3,188,8],[190,3,190,8],[184,3,184,8],[22,1,23,9],[37,1,37,2],[37,3,37,8],[38,1,38,2],[38,3,38,8],[39,1,39,2],[39,3,39,8],[44,1,44,2],[44,3,44,8],[45,1,45,2],[45,3,45,8],[40,1,40,2],[40,3,40,8],[42,1,42,2],[42,3,42,8],[43,1,43,2],[43,3,43,8],[41,1,41,2],[41,3,41,8],[82,3,82,6],[47,1,47,2],[47,3,47,8],[80,3,80,6],[46,1,46,2],[46,3,46,8]]}
[]
[null,"Level Of Support Required:",null,null,{"$f":"CPA!N6","v":"Participation Statement not Completed DO NOT FORWARD"}]
[null,"Workless Household",null,null,{"$f":"CPA!M6","v":"Not Completed"}]
[]
[null,"Reducing Parental Conflict Programme"]
[null,"Referral Stage Questionnaire "]
[null,"For parents expecting their first child who are  no longer in a relationship"]
[null,"together/separated"]
[]
[null,"Please read the following instructions."]
[]
[null,"Please could you answer all questions in Part 1 asking for information relating to you "]
[null,"and your family."]
[]
[null,"Once you have provided your information please move on to Part 2. Please answer "]
[null,"all questions in this section."]
[]
[null,"Once completed please return the questionnaire to the person who gave it to "]
[null,"you."]
[]
[null,"Additional Needs - I have told the person who gave me this questionnaire about anything that might"]
[null,"make it difficult for me to take part (including any needs for interpreters etc.)"]
[null,{"$f":"Questionnaire!M25","v":"Must Complete"}]
[]
[]
[null,"Participation Agreement :",null,null,null,{"$f":"Questionnaire!M31","v":"Must Complete"}]
[]
[]
[null,"PART 1"]
[]
[null,"Parent information"]
[]
[null,"This section collects important information about you and your family."]
[null,"Please complete all questions in this section."]
[]
[null,"About You"]
[]
[null,null,null,"Please complete below"]
[null,"Title",null,{"$f":"Questionnaire!M54","v":"Must Complete"}]
[null,"Forenames",null,{"$f":"Questionnaire!M55","v":"Must Complete"}]
[null,"Surname",null,{"$f":"Questionnaire!M56","v":"Must Complete"}]
[null,"UIN",null,{"$f":"IF(CPA!I10>0, CPA!I10, \"INCOMPLETE\")","v":"TEST"}]
[null,"Date of birth\n(dd/mm/yyyy)",null,{"$f":"Questionnaire!M57","v":"Must Complete"}]
[null,"Telephone\nnumber (mobile)",null,{"$f":"Questionnaire!M58","v":"Must Complete"}]
[null,"Alternative\ntelephone \nnumber (e.g. landline)",null,{"$f":"Questionnaire!M59","v":"No alternative number supplied"}]
[null,"Address",null,{"$f":"Questionnaire!M60","v":"Must Complete"}]
[null,"Post code",null,{"$f":"Questionnaire!M61","v":"Must Complete"}]
[null,"Email",null,{"$f":"Questionnaire!M62","v":"No email address supplied"}]
[]
[null,"What is your gender identity? Please select below."]
[null,{"$f":"Questionnaire!M70","v":"Must Complete"}]
[]
[null,"Disability:"]
[null,{"$f":"Questionnaire!M78","v":"Must Complete"}]
[]
[null,"What is your ethnic group? Select one option that best describes your ethnic group "]
[null,"or background."]
[null,{"$f":"Questionnaire!M114","v":"Must Complete"},null,{"$f":"Questionnaire!L113","v":"None Selected"}]
[]
[]
[null,"Please answer the following questions by selecting your answer."]
[]
[null,"What is your marital status?"]
[null,{"$f":"Questionnaire!M129","v":"Must Complete"}]
[]
[null,"How many children do you have primary or shared care responsibility for?"]
[null,{"$f":"Questionnaire!M138","v":"Must Complete"}]
[]
[null,"Which of these best describes your current employment status?"]
[null,"Please note: if you are on parental leave, you should tick the box of the category you"]
[null,"were in prior to this leave."]
[null,{"$f":"Questionnaire!M155","v":"Must Complete"}]
[]
[null,"Are you presently or have you ever experienced mental health problems? "]
[null,{"$f":"Questionnaire!M166","v":"Must Complete"}]
[]
[null,"What is your relationship with the person you are currently experiencing"]
[null,"conflict with? "]
[null,{"$f":"Questionnaire!M178","v":"Must Complete"}]
[]
[null,"Their name",null,{"$f":"Questionnaire!M185","v":"Co-Parent details not supplied"}]
[]
[null,"Their UIN",null,{"$f":"IF(CPA!I13>0, CPA!I13, \"INCOMPLETE\")","v":"TEST2"}]
[]
[]
[null,"PART 2"]
[]
[null,"There are two sections of questions in this part of the questionnaire. Please answer "]
[null,"all questions to the best of your ability, even if they do not seem entirely relevant to "]
[null,"you. "]
[]
[null,"Once you have finished these questions, please return the questionnaire to the "]
[null,"person who gave it to you. "]
[]
[]
[null,"Section 1:  Interacting with each other"]
[]
[null,"Considering the last 4 weeks, how often does the following occur between you and"]
[null,"your former (Ex) partner/spouse? Please answer as best as you can, selecting your "]
[null,"response for each question"]
[null,"With those times in mind, please indicate how often your spouse/partner acted in the "]
[null,"following ways towards you. During the past 4 weeks, how often did your "]
[null,"spouse/partner…"]
[]
[null,"1. When you & your former partner/spouse discuss parenting issues, how often does it "]
[null,"lead to an argument?"]
[null,{"$f":"Questionnaire!M214","v":"Must Complete"}]
[]
[null,"2. How often is the atmosphere one of hostility and anger?"]
[null,{"$f":"Questionnaire!$M$220","v":"Must Complete"}]
[]
[null,"3. How often are your conversations stressful and tense?"]
[null,{"$f":"Questionnaire!$M$226","v":"Must Complete"}]
[]
[null,"4. Do you and your former partner/spouse have basic differences of opinion"]
[null," about issues related to raising your child / parenting? "]
[null,{"$f":"Questionnaire!$M$233","v":"Must Complete"}]
[]
[null,"5. Is your former partner/spouse helpful to you in preparations for raising your child / children?"]
[null,{"$f":"Questionnaire!$M$239","v":"Must Complete"}]
[]
[null,"6. Would you say that you are helpful to your former partner/spouse in preparations "]
[null,"for  raising your child/children?"]
[null,{"$f":"Questionnaire!$M$246","v":"Must Complete"}]
[]
[null,"10. Do you feel that your former partner/spouse understands and is supportive of your "]
[null,"needs as an expectant parent?"]
[null,{"$f":"Questionnaire!$M$253","v":"Must Complete"}]
[]
[null,"Section 2:  Conflict between parents"]
[]
[null,"Think back over the last 4 weeks and tell us how well you and your former"]
[null,"spouse /partner about have related in the following ways:"]
[]
[null,"1. How well do you share responsibility in plans for raising your child / children?"]
[null,{"$f":"Questionnaire!$M$265","v":"Must Complete"}]
[]
[null,"2. How well do you communicate about your unborn child / children?"]
[null,{"$f":"Questionnaire!$M$271","v":"Must Complete"}]
[]
[null,"3. How often do you agree when making decisions about your unborn child / children?"]
[null,{"$f":"Questionnaire!$M$277","v":"Must Complete"}]
[]
[null,"We would now like to ask how frequently you and your former spouse/partner argue "]
[null,"about each of the following nine topics:"]
[]
[null,"4. Children"]
[null,{"$f":"Questionnaire!M287","v":"Must Complete"}]
[]
[null,"5. Money"]
[null,{"$f":"Questionnaire!M294","v":"Must Complete"}]
[]
[null,"6. Chores and responsibilities"]
[null,{"$f":"Questionnaire!M301","v":"Must Complete"}]
[]
[null,"7. Showing affection (towards each other)"]
[null,{"$f":"Questionnaire!M308","v":"Must Complete"}]
[]
[null,"8. Religion"]
[null,{"$f":"Questionnaire!M315","v":"Must Complete"}]
[]
[null,"9. Leisure time"]
[null,{"$f":"Questionnaire!M322","v":"Must Complete"}]
[]
[null,"10. Drinking"]
[null,{"$f":"Questionnaire!M329","v":"Must Complete"}]
[]
[null,"11. New partners"]
[null,{"$f":"Questionnaire!M336","v":"Must Complete"}]
[]
[null,"12. Relatives"]
[null,{"$f":"Questionnaire!M343","v":"Must Complete"}]
[]
[null,null,null,null,null,"END OF QUESTIONS"]
[]
[]
[]
[]
[null,"For use by staff member"]
[]
[null,"Your Name :",null,{"$f":"Questionnaire!M437","v":"Must Complete"}]
[]
[null,"Job Title :",null,{"$f":"Questionnaire!M439","v":"Must Complete"}]
[]
[null,"Team",null,{"$f":"Questionnaire!M441","v":"Must Complete"}]
[]
[null,"Service",null,{"$f":"Questionnaire!M443","v":"Must Complete"}]
[]
[null,"Email :",null,{"$f":"Questionnaire!M447","v":"Must Complete"}]
[]
[null,"Phone Number :",null,{"$f":"Questionnaire!M449","v":"Must Complete"}]
[]
[null,"Date Completed :",null,{"$f":"Questionnaire!M451","v":"Must Complete"}]
[]
[null,"Local Authority :",null,{"$f":"Questionnaire!M453","v":"Must Complete"}]
[]
[null,"If you have received any of the following training to deliver this programme "]
[null,"please supply date completed"]
[]
[null,"Process Training  / Awareness Overview",null,null,null,null,null,null,null,{"$f":"Questionnaire!$M$460","v":"Please complete"}]
[null,"Practitioner Training supplied by DWP/ Knowledgepool (Online)",null,null,null,null,null,null,null,{"$f":"Questionnaire!$M$464","v":"Please complete"}]
[null,"Practitioner Training supplied by DWP/ Knowledgepool (Classroom Based)",null,null,null,null,null,null,null,{"$f":"Questionnaire!$M$467","v":"Please complete"}]
[null,"Other",{"$f":"Questionnaire!$M$470","v":"Other Training not specified"},null,null,null,null,null,null,{"$f":"Questionnaire!$M$473","v":"Please complete"}]
[]
[]
[null,"Are the family already being supported by any of the following? "]
[]
[null,"No support",null,null,null,null,null,null,null,{"$f":"Questionnaire!M481","v":"Must Complete"}]
[null,"Children's Social Care"]
[null,"Early Help"]
[null,"Other (Please specify below)"]

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[]
[null,"Level Of Support Required:",null,null,{"$f":"Admin!B15","v":"Participation Statement not Completed DO NOT FORWARD"}]
[null,"Workless Household",null,null,{"$f":"CPA!M6","v":"Not Completed"}]
[]
[null,"Reducing Parental Conflict Programme"]
[null,"Referral Stage Questionnaire "]
[null,"For parents expecting their first child who are  no longer in a relationship "]
[null,"together/separated"]
[]
[null,"Please read the following instructions."]
[]
[null,"Please could you answer all questions in Part 1 asking for information relating to you "]
[null,"and your family."]
[]
[null,"Once you have provided your information please move on to Part 2. Please answer "]
[null,"all questions in this section."]
[]
[null,"Once completed please return the questionnaire to the person who gave it to "]
[null,"you."]
[]
[null,"Additional Needs - I have told the person who gave me this questionnaire about anything that might"]
[null,"make it difficult for me to take part (including any needs for interpreters etc.)"]
[null,{"$f":"Questionnaire!M25","v":"Must Complete"}]
[]
[null,"Please give details"]
[null,{"$f":"Questionnaire!L28","v":"Additional Needs not entered"}]
[]
[]
[null,"Participation Agreement :",null,{"$f":"Questionnaire!M31","v":"Must Complete"}]
[]
[]
[null,"PART 1"]
[]
[null,"Parent information"]
[]
[null,"This section collects important information about you and your family."]
[null,"Please complete all questions in this section."]
[]
[null,"About You"]
[]
[null,null,null,"Please complete below"]
[null,"Title",null,{"$f":"Questionnaire!M54","v":"Must Complete"}]
[null,"Forenames",null,{"$f":"Questionnaire!M55","v":"Must Complete"}]
[null,"Surname",null,{"$f":"Questionnaire!M56","v":"Must Complete"}]
[null,"UIN",null,{"$f":"IF(CPA!I10>0, CPA!I10, \"INCOMPLETE\")","v":"TEST"}]
[null,"Telephone\nnumber (mobile)",null,{"$f":"Questionnaire!M58","v":"Must Complete"}]
[null,"Alternative\ntelephone \nnumber (e.g. landline)",null,{"$f":"Questionnaire!M59","v":"No alternative number supplied"}]
[null,"Address",null,{"$f":"Questionnaire!M60","v":"Must Complete"}]
[null,"Post code",null,{"$f":"Questionnaire!M61","v":"Must Complete"}]
[null,"Email",null,{"$f":"Questionnaire!M62","v":"No email address supplied"}]
[]
[null,"How many children do you have primary or shared care responsibility for?"]
[null,{"$f":"Questionnaire!M138","v":"Must Complete"}]
[]
[null,"Which of these best describes your current employment status?"]
[null,"Please note: if you are on parental leave, you should tick the box of the category you"]
[null,"were in prior to this leave."]
[null,{"$f":"Questionnaire!M155","v":"Must Complete"}]
[]
[null,"Are you presently or have you ever experienced mental health problems? "]
[null,{"$f":"Questionnaire!M166","v":"Must Complete"}]
[]
[null,"What is your relationship with the person you are currently experiencing"]
[null,"conflict with? "]
[null,{"$f":"Questionnaire!M178","v":"Must Complete"}]
[]
[null,"Their name",null,{"$f":"Questionnaire!M185","v":"Co-Parent details not supplied"}]
[]
[null,"Their UIN",null,{"$f":"IF(CPA!I13>0, CPA!I13, \"INCOMPLETE\")","v":"TEST2"}]
[]
[]
[null,"PART 2"]
[]
[]
[null,"Section 1:  Interacting with each other"]
[]
[null,"Considering the last 4 weeks, how often does the following occur between you and"]
[null,"your former (Ex) partner/spouse? Please answer as best as you can, selecting your "]
[null,"response for each question"]
[]
[null,"With those times in mind, please indicate how often your spouse/partner acted in the "]
[null,"following ways towards you. During the past 4 weeks, how often did your "]
[null,"spouse/partner…"]
[]
[null,"1. When you & your former partner/spouse discuss parenting issues, how often does it "]
[null,"lead to an argument?"]
[null,{"$f":"Questionnaire!M214","v":"Must Complete"}]
[]
[null,"2. How often is the atmosphere one of hostility and anger?"]
[null,{"$f":"Questionnaire!$M$220","v":"Must Complete"}]
[]
[null,"3. How often are your conversations stressful and tense?"]
[null,{"$f":"Questionnaire!$M$226","v":"Must Complete"}]
[]
[null,"4. Do you and your former partner/spouse have basic differences of opinion"]
[null," about issues related to raising your child / parenting? "]
[null,{"$f":"Questionnaire!$M$233","v":"Must Complete"}]
[]
[null,"5. Is your former partner/spouse helpful to you in preparations for raising your child / children?"]
[null,{"$f":"Questionnaire!$M$239","v":"Must Complete"}]
[]
[null,"6. Would you say that you are helpful to your former partner/spouse in preparations for "]
[null,"raising your children?"]
[null,{"$f":"Questionnaire!$M$246","v":"Must Complete"}]
[]
[null,"7. Do you feel that your former partner/spouse understands and is supportive of your "]
[null,"needs as an expectant parent?"]
[null,{"$f":"Questionnaire!$M$253","v":"Must Complete"}]
[]
[]
[null,"Section 2:  Conflict between parents"]
[]
[null,"Think back over the last 4 weeks and tell us how well you and your former"]
[null,"spouse /partner about have related in the following ways:"]
[]
[null,"1. How well do you share responsibility in plans for raising your child / children?"]
[null,{"$f":"Questionnaire!$M$265","v":"Must Complete"}]
[]
[null,"2. How well do you communicate about your unborn child / children?"]
[null,{"$f":"Questionnaire!$M$271","v":"Must Complete"}]
[]
[null,"3. How often do you agree when making decisions about your unborn child / children?"]
[null,{"$f":"Questionnaire!$M$277","v":"Must Complete"}]
[]
[null,"We would now like to ask how frequently you and your former spouse/partner argue "]
[null,"about each of the following nine topics:"]
[]
[null,"4. Children"]
[null,{"$f":"Questionnaire!M287","v":"Must Complete"}]
[]
[null,"5. Money"]
[null,{"$f":"Questionnaire!M294","v":"Must Complete"}]
[]
[null,"6. Chores and responsibilities"]
[null,{"$f":"Questionnaire!M301","v":"Must Complete"}]
[]
[null,"7. Showing affection (towards each other)"]
[null,{"$f":"Questionnaire!M308","v":"Must Complete"}]
[]
[null,"8. Religion"]
[null,{"$f":"Questionnaire!M315","v":"Must Complete"}]
[]
[null,"9. Leisure time"]
[null,{"$f":"Questionnaire!M322","v":"Must Complete"}]
[]
[null,"10. Drinking"]
[null,{"$f":"Questionnaire!M329","v":"Must Complete"}]
[]
[null,"11. New partners"]
[null,{"$f":"Questionnaire!M336","v":"Must Complete"}]
[]
[null,"12. Relatives"]
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[]
[null,null,null,null,null,"END OF QUESTIONS"]
[]
[]
[]
[]
[]
[null,"For use by staff member"]
[]
[null,"Your Name :",null,{"$f":"Questionnaire!M437","v":"Must Complete"}]
[]
[null,"Local Authority :",null,{"$f":"Questionnaire!M453","v":"Must Complete"}]
[]
[null,"Phone Number :",null,{"$f":"Questionnaire!M449","v":"Must Complete"}]
[]
[null,"Date Completed :",null,{"$f":"Questionnaire!M451","v":"Must Complete"}]
[]
[null,"Additional Information / Risk Assessment Details"]
[null,"Please give details"]
[null,{"$f":"Questionnaire!M486","v":"Additional Information not entered"}]

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[]
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[]
[]
["Conflict between parents"]
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[null,2,{"$f":"Questionnaire!M271","v":"Must Complete"},{"$f":"IF(C18<>\"Must Complete\", C18, 0)","v":0}]
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[]
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[]
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[]
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