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About Yourself

Date of Birth*

Postcode*

Which of the following best describes your parenting role?* [1] Male Care Giver including step parent or sibling guardian

Age of youngest child(ren)* If you have more than one child of the same age (i.e. twins), just pick the matching age range from the list.

Age of additional children Enter the age of each additional child, separated by commas. e.g. 4m, 5y, 5y.
(would represent one 4-month old and 5-year old twins)

What is your ethnic group?*

Asian or Asian British
Indian, Pakistani, Bangladeshi, Chinese, Any other Asian background

Black, Black British, Caribbean or African
Caribbean, African, Any other Black, Black British, or Caribbean background

Mixed or multiple ethnic groups
White and Black Caribbean, White and Black African, White and Asian, Any other Mixed or multiple ethnic background

White : English, Welsh, Scottish, Northern Irish or British, Irish, Gypsy or Irish Traveller, Roma, Any other White background

Other ethnic group : Arab, Any other ethnic group

Disability

You can select multiple options and type any other disabilities you have.

[2] The focus of the Equality Act is on the effect of your mental health problem, rather than the diagnosis. So you need to show that your mental health problem: has more than a small effect on your everyday life, makes things more difficult for you, and, has lasted at least 12 months, is likely to last 12 months, or (if your mental health problem has improved) that it is likely to recur.

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