Covid-19: Understanding the impact on Black, Asian and minority ethnic people in Crawley

We are Citizens Advice in West Sussex (North, South, East).
This survey asks about how Black, Asian and Minority Ethnic people in Crawley have been impacted by Coronavirus. This will inform recommendations to the NHS and others, to meet the needs of our community.

Please help by answering some questions about your experience during Coronavirus, it is anonymous and will take about 20 minutes.
PART 1. ABOUT YOU

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* 1. Where do you live?

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* 2. What best describes your gender?

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* 3. Is your gender identity the same as you were assigned at birth?

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* 4. Age

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* 6. Were you born in the UK?

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* 7. How long have you lived in the UK?

PART 2: NHS SERVICES

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* 8. Are you filling this form on behalf of someone else?

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* 9. Which of these NHS services have you used in the past two years, for yourself or your household?

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* 10. Since the coronavirus pandemic, have any of your appointments with NHS services been cancelled?

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* 11. Tell us more about why the appointment was missed and did this have a negative impact on your health?

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