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Equality and Diversity Family and Friends Forum
1.
What is your age?
Under 18 years
18 – 25 years
26 – 35 years
36 – 45 years
46 – 55 years
56 – 65 years
66 years and over
Prefer not to say
2.
What is your gender?
Male
Female
Other
Prefer not to say
3.
Are you employed?
Yes
No
Prefer not to say
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?
Yes
No
Prefer not to say
5.
If you disclosed a disability above, would you share with us what type of disability or additional need. Please select:
Hearing impairment
Mental health condition
Learning disability/cognitive impairment
Long standing illness or physical health condition
Neurodiverse condition e.g. Autism, ADHD
Visual Impairment
Prefer not to say
Other (please specify)
6.
How would you describe your national identity?
British
Welsh
English
Scottish
Irish
Prefer not to say
Other (please specify)
7.
How would you describe your ethnic group?
White
Black
Asian
Mixed
Gypsy/Traveller
Prefer not to say
Other (please specify)
8.
How would you describe your relationship status?
Married/civil partnership
Single
Separated
Divorced
Widowed
Prefer not to say
9.
How would you describe your Sexual Orientation?
Heterosexual/straight
Gay
Bi-sexual
Prefer not to say
Other (please specify)
10.
Would you describe your gender identity as having changed since birth?
Yes
No
Prefer not to say
11.
How would you describe your religious belief?
Christian
Muslim
Sikh
Hindu
Buddhist
Jewish
No religion
Atheist
Prefer not to say
Other (please specify)
12.
Are you currently pregnant or on maternity leave?
Yes
No
Prefer not to say
13.
Do you consider that you have any unpaid carer responsibilities?
None provided
Daily care for Child under 16
Daily care for age 16-65
Daily care 65+
Prefer not to say
14.
What is your preferred language?
Welsh
English
BSL
Prefer not to say
Other (please specify)
Current Progress,
0 of 14 answered
