Equal Opportunities Monitoring Form

Before you start

Bluestones Medical Complex Care is committed to equality of opportunity and fair treatment in all aspects of employment. We aim to provide a working and learning environment that is free from unfair discrimination and will enable staff to fulfil their personal potential. The Equality Act 2010 protects people from discrimination and promotes equality on the basis of a number of ‘protected characteristics’.

We ask for information on you ‘protected characteristics’ to help us monitor our performance on equality. In line with Government policy, and in accordance with the provisions of GDPR, the information you provide will be held confidentially and it will help us to comply with the law under relevant Acts and to ensure that our employment policies and practices are fair and effective.

IMPORTANT – PLEASE NOTE: You do not have to complete this form. The information is given on a voluntary basis and the information provided will only be used for monitoring purposes. Please do not enter any identifying marks on this form, so that your information remains confidential. This information will be stored on a computer.

Ethnic origin

Please indicate your ethnic origin
Asian or Asian British
Mixed
Other Ethnic Background
Black or Black British
White
Other

Gender

Sexual orientation

Religion or belief

Marital status

Equality Act 2010

Under the terms of the Act, a disability is defined as a “physical or mental impairment which has a substantial and long- term effect on a person’s ability to carry out day-to-day activities”.
As per the Equality Act 2010, do you consider yourself to have a disability?

Caring responsibilities

Do you have any care responsibilities for anyone
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