Exit The Mindful Muslims Programme Question Title * 1. What is your full name Question Title * 2. What is your date of birth? Question Title * 3. What is your ethnicity? (Please select all that apply.) White English Any other White background Welsh Scottish Northern Irish British Irish Gypsy or Irish Traveller White and Black Caribbean White and Black African White and Asian Any other Mixed or Multiple ethnic background Indian Pakistani Bangladeshi Chinese Any other Asian African Caribbean Any other Black, African or Caribbean background Arab Other (please specify) Question Title * 4. What is your gender? Female Male Other Question Title * 5. What is your preferred way of contact? By email By phone No preference Question Title * 6. What is the best email to contact you on? Question Title * 7. What is the best phone number to contact you on? Question Title * 8. We will be collecting your data and following GDPR guidelines and regulations. The data will be used to create a service that best supports the Muslim community. We can only accept your registration of interest if consent is given. Do you consent to your data being used? Yes No Question Title * 9. Thank you for taking the time out of your day to fill in this survey.The data you have given us will be used to best shape our mental health peer to peer support service which will be running from the 29th of July 2023 - 29th July 2024.Please tick this box to confirm you are happy for us to add you to our mailing list as this will contain the details regarding our running times, which group will be running on the Saturday of that month and for you to keep up to date as to any developments with our service. Yes No Done