Tell us about your vulnerabilities

Title

Mrs

Miss

First Name

Surname

Tenancy Reference Number (this will be on the top of your rent statement)

Vulnerability (please tick the ones relevant to you)

I have some difficulty with my mobility

I use a wheelchair

I have some difficulty hearing

I have some difficulty seeing

I am registered as blind

I need help with reading and writing

Please give me extra time to answer the door

Please knock loudly when you visit me

Please contact me by phone before visiting

If you want us to let someone else know when we want to contact you - let us know who

Any other vulnerability not covered above

I consent to STAR Housing holding this information to enable them to provide services to meet my needs and I am happy for them to do so. I also understand that I can, at any time withdraw my consent by informing us in writing

Apply for it

Tell us about your vulnerabilities

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