Aids and adaptions enquiry form

If you or a member of your household thinks you could benefit from an adaptation in your home, contact us by completing an online form or calling us on 0207 089 1026.

Full name (Required)

Full address (Required)


Contact number

Email address (Required)

Do you consider yourself or any member or your household to have a disability?Please give details below

Do you have any existing aids or adaptations in or to your home?Please give details below


Please select which aids or adaptations you feel you or a household member could benefit from:
Over bath shower

Level access shower

Marking of parking bay

Grad/stair rails

Lever arch taps

Lever arch windows

Door entry system

Stair lifts

Ramps

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Aids and adaptions enquiry form