Sign up

Login

Data Collection Form

Live Lighter Sheffield is commissioned by Sheffield City Council to provide free weight management services to the people of Sheffield. As part of this offer, we are committed to ensuring our services are inclusive for all. To ensure we are doing this, we would be grateful if you could answer the questions below.

We very much appreciate you taking the time to answer our questions and enable us to improve access for all of our clients.

    Your Details

    Full Name

    Email Address

    Ethnicity

    White

    Asian or Asian British

    Black or Black British

    Other ethnic group

    Mixed/multiple heritage

    Disability

    A disability is an impairment that has (or is likely to have) a substantial (more than minor), adverse, long-term (more than a year) effect on the ability to carry out normal day-to-day activities.

    Do you consider yourself to be a disabled person?

    If you have answered yes, please tick the box(es) below that best describe your impairment(s). We list a few examples but recognise many other conditions could also be listed.

    Sexual orientation

    Religion/belief