Use this form if you are a council tenant and need help with home maintenance because of your age, disability or health needs.
Before you start, read Help with council home maintenance to find out what support is available, whether you are eligible and what information you will need to complete the form.
Please note:
- this form usually takes about 10 minutes to complete
- the form will time out after 1 hour of no activity and any information you have entered will be lost
