Bath Mind Equal Opportunities Form

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Equality and diversity monitoring form

Bath Mind wants to meet the aims and commitments set out in its equality policy. This includes not discriminating under the Equality Act 2010, and building an accurate picture of the make-up of the workforce in encouraging equality and diversity.

The organisation needs your help and co-operation to enable it to do this, but filling in this form is voluntary. The hiring manager for your role will not see your answers to the form below. We will not use your answers to determine whether you require reasonable adjustments an interview, so if you would like to discuss adjustments, please get in touch with Recruitment at: recruitment@bathmind.org.uk

Is your gender identity the same as your gender/sex assigned at birth?
Are you married or in a civil partnership?
Age

What is your ethnicity?

Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong. Please tick the appropriate box
Do you consider yourself to have a disability or health condition?

The information in this form is for monitoring purposes only. If you believe you need a ‘reasonable adjustment’, then please discuss this with your manager, or the manager running the recruitment process if you are a job applicant.

What is your sexual orientation?
What is your religion or belief?
What is your current working pattern?
Do you have caring responsibilities? If yes, please tick all that apply

Confidentiality and Data Protection

 

Bath Mind is committed to maintaining client confidentiality. All information about you is held securely and not shared with anyone outside our organisation without your permission, or unless exceptional circumstances occur.

If you wish to see the records we hold about you this can be arranged by request to the Chief Executive Officer of Bath Mind. If we believe there is a risk of harm to you or someone else we will inform the appropriate person (such as your GP or other health professional), but we would always endeavour to discuss this with you in advance.

 

For further information please view our Privacy Policy

 

Declaration:

  • I declare that the information provided by me is accurate to the best of my knowledge.
  • If I choose to go ahead and receive counselling through this service, I hereby authorise Bath Mind to store personal information related to me and the service I receive.
  • If you are happy to accept the above terms and conditions please tick the following box and click on the button marked submit.
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