Accessibility and Diversity Monitoring Form

We need your explicit consent to use some information, including your ethnicity, religion, disabilities & sexual orientation. Providing this information is optional and if you agree, we’ll use this information, which is known as ’special category personal data’ to:
• help us monitor accessibility and diversity at Daisy Chain
• help us to gather data to continue & improve our services
Any information provided will be kept confidential and secure. By providing the information below you consent to Daisy Chain recording the special category personal data you choose to provide.

Your details:


Marital Status


Sexual Orientation

Your employment status

Your Religion

Daisy Chain

Ethnicity (please tick one box only)

Thank you for taking the time to complete this form.