Ethnicity Data

In line with government guidance, we are asking our patients to inform us of their ethnicity to complete their medical record. COVID-19 has affected certain populations in the UK differently, so in order to plan recovery in a way that inclusively supports those at greater risk, it is important we have this data on record.

Ethnicity Data

About You

Please use this date format: DD/MM/YYYY.

Ethnicity

Please select your ethnic background from the options below: *
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