South East London Engagement Demographic Survey | Let’s Talk Health and Care South East London

1.

Please select what you consider your ethnic origin to be.

Asian or Asian British - Indian

Asian or Asian British - Bangladeshi

Asian or Asian British - Pakistani

Asian or Asian British – Chinese

Any other Asian background

Black or Black British - African

Any other Black background

Black or Black British - Caribbean

Mixed - White and Asian

Mixed - White and Black African

White English, Welsh, Scottish, Northern Irish or British

White Irish

White Gypsy or Irish Traveller

Mixed - White and Black Caribbean

White Latin American

White Roma

White Other

Other - Arab

Other - Vietnamese

Other – Latin American

Any other Mixed or multiple ethnic background

Prefer not to say

Prefer to self describe as (please specify in the box below)

2.

Which borough do you live in

3.

What language (s) do you speak

English

Arabic

French

Portuguese

Romanian

Spanish

Prefer not to say

Other (please specify)

4.

Sexual orientation

5.

Religion

6.

Neurodiversity e.g. Autism/ASD,ADHD, AuDHD, Dyslexia, Dyspraxia)