Appendix B: DEMOGRAPHIC MONITORING FORM Health and Wellbeing Event: Demographic Monitoring Form We would like to know more about you in order to ensure that we are involving a wide range of people throughout the organisation. The information you give on this form will help us to monitor and plan our activities. The form will remain entirely confidential – your name will not be associated with it in any way. Many thanks for your help.
1.
How old are you? Under 18 18-24 25-34 35-44 45-54 55-64 65+ Prefer not to say
2.
Gender Identity: Which of the following describes how you think of yourself? Man (including trans man) Woman (including trans woman) Non-binary In another way Prefer not to say
3.
Trans Status: Is your gender the same as the gender you were given at birth? Yes No
4.
Sexual Orientation: Which of the following describes how you think of yourself? Gay Straight Lesbian Bisexual Prefer not to say
5.
What is your religion? No religion Christian Buddhist Hindu Jewish Muslim Sikh
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