First Name Last Name Email Age How do you identify? Please select any that apply to you ... Ethnicity South Asian (eg Indian, Bangladeshi, Pakistani, Sri Lankan or mixed heritage) Black Ethnic groups (eg Black African, Black Caribbean or mixed heritage) Gender Identity and Sexuality Trans and Non-Binary/Genderqueer Lesbian and women in same sex relationships Please select to indicate you available on one of the focus group dates indicated above? Have you accessed any of our support services before? Yes No Have you been diagnosed endometriosis? Yes No Do you agree for us to pass this information on to our research partner Diverse Matter? All information will be held on our secure database until the transformation of data to Diverse Matters is complete, at which point it will be deleted.
