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Creative Health Network Monitoring Survey

Thank you for joining the Creative Health Network.

We want to ensure that the network is inclusive and useful to all local residents. To check how we are doing, we will periodically ask members to complete this completely anonymous form to provide us with a snapshot of our reach. 

We would really appreciate any information you are happy to share; you can skip any questions in the form that you do not want to answer. 

Privacy statement

Personal data submitted (including names, addresses, contact details and any equalities data) will be processed in accordance with the requirements of the UK General Data Protection Regulations. Data will only be used for the purposes of monitoring this scheme. Details of individual responses will not be shared or published. By participating, you agree to your data being used in this way.

For further information on how we use, share and protect your personal data in compliance with our legal requirements under the GDPR 2018 and Data Protection Act 2018, please refer to the council’s corporate privacy notice:

Croydon Council's Privacy Statement: https://www.croydon.gov.uk/council-and-elections/privacy-and-open-data/privacy-notices/corporate-privacy-notice

1.  

What is your sex?  (a question about gender identity will follow if you are aged 16 or over)

2.  

Are you aged 16 or over?

3.  

This question is for respondents aged 16 and over:  Is the gender you identify with the same as your sex registered at birth? 

4.  

Which of the following best describes your sexual orientation?

5.  

Which age range are you in?

6.  

How would you describe your ethnicity?

7.  

Currently, what is your legal marital or registered civil partnership status?

8.  

Have you or your partner had a baby in the last 12 months?

Disability

The Equality Act 2010 defines someone as a disabled person if they have a physical or mental impairment which has a long term and substantial adverse effect on their ability to carry out normal day to day activities.        

A disability may include progressive conditions such as HIV and cancer, mobility, sight or hearing impairments or mental health issues such as depression.            

 In considering whether you have a disability you should not take into account the effect of any medication or treatments used or adaptations made which reduce the effects of an impairments (other than glasses or contact lenses used to correct a visual impairment)

9.  

Do you consider yourself to have a disability, neurodivergence or long term health condition?

10.  

Please select any disabilities, neurodivergence and/or long term health conditions you consider yourself to have:

11.  

What was the occupation of your main household earner when you were aged about 14?

12.  

What is your religion?

13.  

Which Croydon ward do you live in?