Plus services referral form

Comments

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Data protection

I understand the information I provide will be managed in accordance with Data protection legislation and 麻豆社 privacy notice which is available on our website . All information provided will be held securely and only used for the purpose of assisting you with employment and money advice.

I understand in some circumstances it may be necessary for 麻豆社 to discuss my personal circumstances and share the information with colleagues in the wider 麻豆社. This information will not be discussed with third parties, unless you provide consent, or the law requires us to do so. If you have any questions, you can contact data.protection@housingplusgroup.co.uk, or you can call our customer service centre on 0800 048 8955.

If you do not have their consent, please do not complete or submit this form.

Date

Referrer details

Agency

Email

Phone

Client details

Date of birth

Gender

Ethnicity

Email address

Home phone

Mobile phone

When is the best time to call?

Please provide further details if answered yes.

Please provide brief details of the advice/support you need and anything else that you think might be useful for us to know:

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