Service User Monitoring Information
Answers marked with a * are required.
Your Age


The Disability Discrimination Act 1995 (DDA) protects disabled people from discrimination. The DDA defines a person as disabled if they have a physical or mental impairment, which has a substantial and long term (i.e. has lasted or is expected to last at least 12 months) and has an adverse effect on the person’s ability to carry out normal day-to-day activities.

Do you consider yourself to have a disability according to the terms given in the DDA?


If you have answered yes, please indicate the type of impairment which applies to you (by clicking next to it below).  People may experience more than one type of impairment, in which case click in all the types that apply. If your disability does not fit any of these types, please click on Other.


Your ethnic group
Asian, Asian British, Asian English, Asian Scottish, or Asian Welsh


Black, Black British, Black English, Black Scottish, or Black Welsh


Chinese, Chinese British, Chinese English, Chinese Scottish, or Chinese Welsh, or other ethnic group






Your gender


Your religion or belief
Which group below do you most identify with?


Your sexual orientation



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