Patient Demographics

Engaging Communities (ECS) is an independent, community interest company that works to give the public a voice in the way that health and social care services are delivered. Burton Hospital Foundation Trust (BHFT) has commissioned ECS to capture and explore the experience of service users, carers and the general public to ensure that BHFT are delivering an excellent service. 

The survey will take approximately 10-15 minutes to complete and your response will be entirely anonymous and confidential. 
Your participation is greatly appreciated. 

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* 1. What is your age?

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* 2. Do you have a disability? (i.e physical, mental or sensory)

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* 3. What is your marital status?

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* 4. Are you pregnant or have you recently had a baby?

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* 5. What is your nationality?

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* 6. What is your religion (if any)?

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* 7. What is your sexual orientation?

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* 8. Would you consider yourself to be trans-gender?

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