Your health needs - Supporting our ethnically diverse residents - About you - The Royal Borough of Kingston upon Thames

1. Which of the following best describes you?

(Required) I live in Kingston and use local health or care services I live in Kingston and do not use local health or care services I do not live in Kingston but use health or care services in Kingston I support or care for someone who lives in Kingston or uses services in Kingston (for example as an unpaid carer, family member or friend) Other

If other, please specify in the space provided

2. What is your ethnic group?

(Required) White - English / Welsh / Scottish / Northern Irish / British White - Irish White - Gypsy or Irish Traveller White - Any other White Background (please specify) Mixed / Multiple ethnic groups - White & Black Caribbean Mixed / Multiple ethnic groups - White & Black African Mixed / Multiple ethnic groups - White & Asian Mixed / Multiple ethnic groups - Any other Mixed / Multiple ethnic background (please specify) Asian or Asian British - Indian Asian or Asian British - Pakistani Asian or Asian British - Bangladeshi Asian or Asian British - Chinese Asian or Asian British - Sri Lankan Asian or Asian British - Korean Asian or Asian British - Any other Asian background Black / African / Caribbean / Black British - Caribbean Black / African / Caribbean / Black British - African Black / African / Caribbean / Black British - Any other background (please specify) Arab Middle Eastern / North African (please specify) Any other ethnic group Prefer not to say

If you have selected 'Any other ethnic group' please use the space provided to tell us more