Use this online form to request a home visit to find out what benefits you might be entitled to. You can also request a home visit if you need help to complete a claim form.
Please note: this service is only available if you are unable to leave your home. For example if you’re disabled or have caring responsibilities.
Before you start
In this form you'll be asked to provide information about:
- yourself
- an appointee if applicable
- your social worker or other relevant contacts
- your GP
- the care you currently receive
- the benefits you receive
- why you would need a home visit
- any forms that need completing during the visit
How we use your data
The council primarily use your data for assisting with your referral. This may be shared with the NHS and other government departments in accordance with our organisational privacy notice. We never sell your data to third parties or use it to market to you without your consent.