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Gender Identity
Do you/have you ever identified as transgender?
Sexual Orientation
Do you consider yourself to have a disability or long-term condition that has a substantial impact on your ability to carry out day-to-day activities (including sight or hearing loss)?
Do you consider yourself to be neuro-diverse? (i.e, on the autism spectrum)
Do you have a learning difference? (This can include dyslexia etc.)

Ethnicity

Asian
Black
Other ethnic group
Mixed
White
Other
Religion and Belief
Relationship Status

Other Information

Are you a carer?

Data Protection

In accordance with our Privacy Statement, we take care to ensure all personal data is appropriately and securely stored and handled. Any information supplied will be kept securely for a period of six months and then will be destroyed.

For further information about our privacy practices, please contact the
individual in charge of GDPR compliance:

Writeto:
Dorset Mind, 8 Stratfield Saye, 20-22 Wellington Road, Bournemouth, BH8 8JN

Callus on:
01202 315329

Emailto:
contact@dorsetmind.uk

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