Yes No Prefer not to say If you do consider yourself to have a disability, please indicate which of the following most closely describes it: (please tick all that apply) Mobility (Getting Visual impairment Deaf/Heard of Hearing around) Use of hands/fingers Learning Mental Health Issue Difficulties Other (Please explain): Which of the following ethnic groups do you most closely associate with? (please tick one answer) White: British Irish Any other White background Black/African/Caribbean/Black British: African Caribbean Any other Black background Mixed/Multiple Ethnic Groups: White & Black White & Asian White & Black Caribbean African Any other Mixed background Asian/Asian British: Bangladeshi Indian Pakistani Chinese Any other Asian background
Yes No Prefer not to say If you do consider yourself to have a disability, please indicate which of the following most closely describes it: (please tick all that apply) Mobility (Getting around) Visual impairment Deaf/Heard of Hearing Use of hands/fingers Learning Difficulties Mental Health Issue Other (Please explain): Which of the following ethnic groups do you most closely associate with? (please tick one answer) White: British Irish Any other White background Black/African/Caribbean/Black British: African Caribbean Any other Black background Mixed/Multiple Ethnic Groups: White & Black African White & Asian White & Black Caribbean Any other Mixed background Asian/Asian British: Bangladeshi Indian Pakistani Chinese Any other Asian background
PUBLIC-QUESTIONNAIRE-v6-221014.docx