Chinese Any Chinese background (specify below if you wish) Do not wish to answer Other information you wish to specify Part E: Disability monitoring The Disability Discrimination Act 1995 (DDA) defines a disabled person as someone with a physical or mental impairment, which has a substantial and long-term adverse effect of at least one year on a person’s ability to carry out normal day-to-day activities. Do you consider yourself to be disabled as defined in the Disability Discrimination Act? Yes No If you are selected for interview will you require any additional arrangements at interview? If so please specify below: Part F: Sexual orientation Which of the following best describes how you think of yourself? Bisexual A gay man A gay woman / lesbian Heterosexual Other (please specify) Do not wish to answer Part G: Religion What is your religion? No Religion Jewish Buddhist Muslim Christian Sikh Hindu Do not wish to answer Any other religion (please specify)? Please return the completed questionnaire together with your application form. This form will not be disclosed to anyone involved in assessing your application.
Chinese Any Chinese background (specify below if you wish) Do not wish to answer Other information you wish to specify Part E: Disability monitoring The Disability Discrimination Act 1995 (DDA) defines a disabled person as someone with a physical or mental impairment, which has a substantial and long-term adverse effect of at least one year on a person’s ability to carry out normal day-to-day activities. Do you consider yourself to be disabled as defined in the Disability Discrimination Act? Yes No If you are selected for interview will you require any additional arrangements at interview? If so please specify below: Part F: Sexual orientation Which of the following best describes how you think of yourself? Bisexual A gay man A gay woman / lesbian Heterosexual Other (please specify) Do not wish to answer Part G: Religion What is your religion? No Religion Jewish Buddhist Muslim Christian Sikh Hindu Do not wish to answer Any other religion (please specify)? Please return the completed questionnaire together with your application form. This form will not be disclosed to anyone involved in assessing your application.
SPEC%20NHS%20Digital%20Monitoring%20Forms%20Jan%202017.DOCX