Demographics Monitoring Form

Completing this form helps us to identify any existing inequalities and where new inequalities may be developing and take action to tackle them.

While it is voluntary to tell us about this information, doing so will help us to better understand and address any disparities. Your answers will be treated in confidence, and all data disclosed will comply with the General Data Protection Regulations and any related data protection requirements. In completing this, you are giving us permission to collect and store the data anonymously to help us with our improvement plans. That means we will not hold this data on your records but use it to help us find out more about the wider make up of our communities.

Demographics Monitoring Form

The answers you give will be sent securely to the practice to be reviewed by the appropriate team member in the practice. Your answers will be used by the practice to identify you and to make decisions about your care. Please answer all questions as accurately as possible, and take any advice offered. You may be offered specific advice, or be advised to seek alternate help.

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Although a parent or carer can use this system to contact a GP and seek health advice about under 16s, only people who are 16 years old or over can complete the questions in this service.

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Terms of use

Your GP Practice has made this online service available to you. You must use this service in accordance with the Practice's terms and conditions of use.

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