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Home / Forms / Housing / Understanding your needs

Understanding your needs

Personal Details

Understanding Your Needs 1. Please supply your date of birth (this helps us identify age related services)

2. If you have any disabilities/impairments please tell us what they are. The Disability Discrimination Act 1995 defines a disability as a 'physical or mental impairment which has a substantial and long term adverse effect on your ability to carry out normal day-to-day activities.' Tick all boxes that apply.

Ethnic Group

3. Please tell us your ethnic group. Tick the box that applies.

Additional Information

5. What is your religion, faith or belief?

6. Please tell us what gender you are.

7. What is your sexual orientation?

Contact Details

9. Please provide your name, address, contact telephone number and your email address.

10. How do you prefer us to contact you?

Related Information

 

Postal Address Customer Services Centre,
St Stephens Road, Bournemouth, Dorset
BH2 6EB
Telephone 01202 451451
Minicom 01202 454974
Email Enquiries
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