The diversity, inclusion and equality questionnaire

The Diversity, Equality and Inclusion Statement

This is a generic opening statement for the diversity questionnaire and can be amended from the Question template lookup table.

We would like to take a moment to express our gratitude for your participation in our online diversity questionnaire. At [insert company], we believe that diversity is not just a buzzword, but a cornerstone of our values.

We understand that our workforce is made up of individuals with unique experiences, perspectives, and backgrounds, and we embrace these differences as a means of enriching our workplace culture. We are committed to fostering an inclusive environment where everyone feels valued, respected, and supported.

Our goal is to create a workplace where all employees have the opportunity to thrive and succeed, regardless of their race, ethnicity, gender identity, sexual orientation, religion, age, disability, or any other characteristic. We recognize that achieving this goal requires ongoing effort and a commitment to continuous improvement, and we are dedicated to that effort.

We encourage you to continue to engage with us in this journey towards greater diversity and inclusivity. Your participation in our online diversity questionnaire is just one step in this ongoing effort, and we appreciate your willingness to be a part of it.

If you’d like to know more, please check out our diversity statement at [insert location].

Data Protection Statement

At [insert company], we take the protection of your personal data very seriously. As such, we are committed to ensuring that any personal information we collect and process is done so in accordance with the Data Protection Act 2018 and the General Data Protection Regulation (GDPR).

We will only collect personal information that is necessary for the purposes for which it is processed, and we will ensure that this data is kept accurate, up-to-date, and secure. We will not share your personal data with third parties unless we are legally required to do so, or unless we have your explicit consent.

Under the GDPR, you have certain rights in relation to your personal data, including the right to access, correct, and delete your personal information. You also have the right to restrict or object to the processing of your personal data in certain circumstances. If you wish to exercise any of these rights, please contact our Data Protection Officer using the contact details provided below.

We have implemented appropriate technical and organizational measures to ensure the security of your personal data and to protect against unauthorized or unlawful processing, accidental loss, destruction, or damage. We regularly review and update our security measures to ensure that they remain effective.

If you have any questions or concerns about how we collect and process your personal data, please do not hesitate to contact our Data Protection Officer at [insert contact details here].

Question 1 of 8

A disabled person is defined under the Equality Act 2010 as someone with a ‘physical or mental impairment which has a substantial and long term adverse effect on that person’s ability to carry out normal day-to-day activities.’

Do you consider yourself to be disabled?

⚪ Yes

⚪ No

⚪ Don't know

⚪ Prefer not to say

All responses are optional and kept confidential as per our data protection statement.

Question 2 of 8

Historically, the medical model has been the predominant way of thinking about disability, where an individual is defined by their condition. The choices below are based on the medical model.

Please select the options that apply to you.

⬜ Impaired vision

⬜ Impaired hearing

⬜ Impaired mobility

⬜ Impaired dexterity

⬜ Impaired learning or understanding or concentrating

⬜ Impaired memory

⬜ Impaired mental health

⬜ Impaired staima or breathing or fatigue

⬜ Impaired socially or behaviourally

Other (please specify)

__________

All responses are optional and kept confidential as per our data protection statement.

Question 3 of 8

We use the social model to inform disability action planning. This means concentrating on the environment and removing barriers wherever possible that get in the way of a disabled person from doing their job.

In order to be successful in your role, do you require any reasonable adjustments to be put in place? Please specify in the box below.

__________

If you feel any of your requirements are not being met, please get in touch with HR so we can help.

Question 4 of 8

How would you describe your national identity?

⚪ British or Mixed British

⚪ English

⚪ Irish

⚪ Scottish

⚪ Welsh

Any other? (please specify)

__________

Question 5 of 8

What is your ethnic group?

White

⚪ English, Welsh, Scottish, Northern Irish or British

⚪ Irish

⚪ Gypsy or Irish Traveller

⚪ Roma

Any other White background

__________

Black, Black British, Caribbean or African

⚪ Caribbean

⚪ African

⚪ Any other Black, Black British, or Caribbean background

__________

Asian or Asian British

⚪ Indian

⚪ Pakistani

⚪ Bangladeshi

⚪ Chinese

Any other Asian background

__________

Mixed or multiple ethnic groups

⚪ White and Black Caribbean

⚪ White and Black African

⚪ White and Asian

Any other Mixed or multiple ethnic background

__________

Other ethnic group

⚪ Arab

Other ethnic group

__________

These categories were used in the 2021 Census and are listed alphabetically.

Question 6 of 8

This question is voluntary.

Is your gender the same as the sex you were registered at birth?

⚪ Yes

⚪ No

⚪ Prefer not to say

If your gender is not the same as the sex recorded on your birth certificate when you were born (for example, you are transgender or non-binary), tick “No”.

If you answered no, please enter the term you use to describe your gender. This is also voluntary, so you can leave it blank if you prefer.

If you would like to record that you have variations of sex characteristics, sometimes also known as intersex, you can use this write-in box. If you would like to, you can also write-in your gender (for example: ‘intersex, non-binary’). 

Question 7 of 8

The purpose of the question is to help find out how many people in the population are lesbian, gay or bisexual. Together with other data your response will be used to monitor equality of opportunity. This will help identify discrimination and disadvantage experienced amongst our colleagues on the basis of sexual orientation.

What is your sexual orientation?

⚪ Bi-Sexual

⚪ Gay woman/lesbian

⚪ Gay man

⚪ Heterosexual/straight

⚪ Prefer not to say

Other (please specify)

__________

Question 8 of 8

It's important to us that we offer a safe and welcoming place to work for all people regardless of their religious beliefs.

Monitoring this allows us to support our colleagues and foster an inclusive environment.

What is your religion?

⚪ Agnostic

⚪ Atheist

⚪ Bah’ai

⚪ Buddhist

⚪ Christian – Catholic

⚪ Christian – Protestant

⚪ Christian – Other

⚪ Hindu

⚪ Humanism

⚪ Jain

⚪ Jewish

⚪ Muslim

⚪ Pagan

⚪ Rastafarian

⚪ Scientologist

⚪ Shinto

⚪ Sikh

⚪ Zoroastrian

⚪ No religion or belief

⚪ Prefer not to say

Any other religion or belief

__________

Closing statement

Thank you for taking the time to complete this questionnaire. It really helps us provide a better work environment for everyone.

From the HR team.

This is an example where an employee has submitted a free-text response for the impairments question.

The validation page provides a way to amend any values before they are saved to the employees main personnel record. Please note that all responses are saved with their original and unedited values in the Questionnaire response table. The validated and amended responses are saved to the Personnel record to allow for more consistent reporting.

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In this example the data controller could potentially classify the free-text response as being related to impaired concentration. Ticking the impaired concentrating checkbox and then Update impairments with new value will update the personnel record with the value chosen.

Disability and Impairments

Shows the disability and impairment status for current employees

Ethnicity and Nationality pivot output

Provides an anonymised output of ethnicity and nationality data that can be used in excel pivot tables.

Gender pivot output

Provides an anonymised output of gender and sexuality data that can be used in excel pivot tables.

Questionnaire return review

An anonymised report showing all question responses for questionnaires returned since a given date.

No completed questionnaire return in 12 months

Show any current personnel that have not completed a DEI questionnaire in the last 12 months.