Luton Cancer Questionnaire
Luton Clinical Commissioning Group (CCG) is responsible for organising and purchasing NHS funded healthcare for the people of Luton. The CCG would like to understand why local residents are currently choosing to take part in cancer screening or not. We would appreciate it if you could spare a few minutes to complete this short questionnaire.
What is your age?
What is your gender?
Do you live in the borough of Luton?
What is your employment status?
Long term sick
Do you consider yourself to have a disability (physical or mental)?
If yes, please state your disability in the space below
Are you registered with a GP practice?
If yes, which is your GP practice?
Which best describes your ethnicity?
White English, Welsh, Scottish, Northern Irish, British
White Gypsy/ Irish Traveller
Any other white background
Any other Asian background
White and black African
White and black Caribbean
White and Asian
Any other Black/ African/ Caribbean background
Any other mixed/ multiple ethnic background
Any other ethnic group
What is the main language spoken at home?
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