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* 1. What is your age?

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* 2. What is your gender?

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* 3. Are you employed?

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* 4. The Equality Act 2010 defines a disabled person as a person that has a physical or mental impairment, which has a substantial and long-term adverse effect on the person’s ability to carry out normal day-to-day activities (i.e. has lasted or is expected to last at least 12 months).

Would you consider under the Equality Act that you have a disability?

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* 5. If you disclosed a disability above, would you share with us what type of disability or additional need. Please select:

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* 6. How would you describe your national identity?

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* 7. How would you describe your ethnic group?

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* 8. How would you describe your relationship status?

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* 9. How would you describe your Sexual Orientation?

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* 10. Would you describe your gender identity as having changed since birth?

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* 11. How would you describe your religious belief?

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* 12. Are you currently pregnant or on maternity leave?

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* 13. Do you consider that you have any unpaid carer responsibilities?

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* 14. What is your preferred language?

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