Tell us whether you accept cookies

We've put some small files called cookies on your device to make our site work. We would also like to use analytical cookies to understand how our site is used and improve user experience. Analytical cookies send information to Google Analytics.

Let us know your preference. We will use a cookie to save your choice. Before you make your choice you can read more about our cookie policy.

Foundation Surgery NHS GP surgery

Record your ethnicity

Form summary

What is your ethnic group? *

White: English, Welsh, Scottish, Northern Irish or British

White: Irish

White: Gypsy or Irish Traveller

White: Roma

White: Any other White background

Mixed or multiple ethnic groups: White and Black Caribbean

Mixed or multiple ethnic groups: White and Black African

Mixed or multiple ethnic groups: White and Asian

Mixed or multiple ethnic groups: Any other Mixed or multiple ethnic group background

Asian or Asian British: Indian

Asian or Asian British: Pakistani

Asian or Asian British: Bangladeshi

Asian or Asian British: Chinese

Asian or Asian British: Any other Asian background

Black, Black British, Caribbean or African: Caribbean

Black, Black British, Caribbean or African: African

Black, Black British, Caribbean or African: Any other Black, Black British, Caribbean or African background

Other ethnic group: Arab

Other ethnic group: Any other ethnic group

Prefer not to say

Provide your ethnic group *

Terms and conditions *

I confirm that this is not an emergency and understand the surgery cannot help while it is closed. If I need help right now, I will use the NHS 111 service. In an emergency, I will call 999 or go to A&E.

If you are human, leave this field blank.

Address Line 1
Address Line 2
Town
County
Postcode

Get directions

01234 567 890

Feedback and complaints

Wellbeing

Accessibility statement

Website policies