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Personal Information

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Employment

Are you currently employed at least 16 hours per week at chair side?
Within this role are you being paid at least the National Minimum Wage?
Have you been provided with a contract of employment?
Do you have use of a laptop or tablet? (MS Word is required for your work production on the eportfolio system)

Equal Opportunities Data

Gender
Do you have any learning difficulties and/or health problems which affect your ability to carry out day-to-day activities?
Visual Impairment
Hearing Impairment
Disability affecting mobility
Other physical disability
Other (e.g epilepsy, asthma, diabetes)
Emotional / behavioural difficulties
Mental health difficulty
Profound complex disabilities
Asperger's Syndrome
Dyslexia
Dyscalculia
Autism spectrum disorder
Multiple learning difficulties
Other

Ethnicity

Mark which box best describes you: