Dorset Design Code Survey

1. Which area of Dorset do you live in?

If you wish to type in a location that is not listed, please select 'other, please specify' in the drop down list to continue

Please select the area that most accurately reflects where you live (Required)

If you selected 'Other' above, please specify here:

2. Please tell us which age range you are in

Under 18 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 and over Prefer not to say

3. What is your sex?

Male Female Prefer not to say

4. The Equality Act 2010 describes a person as disabled if they have a longstanding physical or mental condition that has lasted or is likely to last 12 months; and this condition has a substantial adverse effect on their ability to carry out normal day-to-day activities. People with some conditions (cancer, multiple sclerosis and HIV/AIDS for example) are considered to be disabled from the point that they are diagnosed. Do you consider yourself to be disabled as set out in the Equality Act 2010?

Yes No Prefer not to say

5. If at the previous question you stated you consider yourself to have a disability, please state the type of disability which applies to you.

Attention Deficit Disorder (ADD) Attention Deficit Hyperactivity Disorder (ADHD) Autistic Spectrum Conditions Blind Dyscalculia Dyslexia Dyspraxia Deaf Hearing loss Long term health condition Mental health issues Physical impairment Sign Language User Visually impaired Medical conditions Mobility issues Learning disability Specific learning differences Wheelchair user

If you prefer to use another term, please tell us here:

6. If you'd like, please tell us your email address so that we can contact you in the future about the Design Code

Email address

7. Could you tell us more about where you live?

(If yes, there will be a few more questions. If no, you'll continue to the end of the survey)

(Required) Yes No

Dorset Design Code Survey

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