EMHP Parent Wellbeing Questionnaire

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1. What age range do you fall into? *

18-24
25-34
35-44
45-54
55-64
65-74
75+
Prefer not to say

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2. What gender do you identify with? *

Male
Female
Prefer not to say
Other (please specify):

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3. What is your ethnic background? *

White
British
Irish
Other
Asian or Asian British
Indian
Pakistani
Bangladeshi
Any other Asian background
Mixed
White and Black Caribbean
White and black African
White and Asian
Any other mixed background
Black or Black British
Caribbean
African
Any other black background
Other Ethnic Group
Chinese
Any other Ethnic Group
I do not wish to disclose my ethnic origin
Other (please specify):

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