Survey for Victims/Survivors of Domestic Abuse (DA) and Violence Against Women and Girls (VAWG) - Page 1 of 10 - Lewisham Council

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Demographic Information

The following monitoring questions help us to be fair and inclusive in the work that we do. All of these questions are OPTIONAL and you do not have to answer them.

The personal data that you do provide is used to help us understand who is sharing their views and influencing our decision-making, though your identity will remain anonymous.

This data is also used to ensure that nobody is discriminated against unlawfully in the provision of our functions and services.

Any personal data that you choose to share will be treated confidentially in accordance with the General Data Protection Regulations (GDPR).

1. What is your age?

Please select one of the following from the dropdown list:

2. What is your gender?

3. Is your gender identity different from the gender you were assigned at birth?

If your gender identity is different to that which you were assigned at birth you may choose to share this here. You do not have to do this, but it may help us to understand the impact of our policies or service changes on transgender people.

4. What is your ethnicity?

If you have selected 'Other' then please describe your ethnicity in the box below:

5. Disability

These questions relate to disability. Disability is defined in the law as a physical or mental impairment which has a sustained and long-term adverse effect on a person's ability to carry out normal day to day activities. This includes health conditions such as HIV, cancer and multiple sclerosis.

If you selected 'Other' then please describe your disability in the box below:

If you selected 'other' then please describe your access requirements in the box below:

6. How would you define your sexual orientation?

Please select one of the following from the dropdown list:

If you have selected 'Other' then please describe your sexual orientation in the box below:

7. What is your religious belief?

Please select one of the following from the dropdown list:

If you have selected 'Other' then please describe your religion or belief in the box below:

8. Language

9. What is your Immigration Status?

If you have selected 'Other' then please describe your immigration status in the box below:

10. What is your current living situation?

If you have selected 'Other' then please describe your current living situation the box below: