WORRIED ABOUT BOGUS CALLERS?

Please answer questions below to send the referral form to your local authority. The local authority will contact you within 2 to 5 days to make an appointment.

Do you live alone?
Yes No
Do you have a house alarm?
Yes No
Can you hear visitors when they knock or ring at your door?
Yes No
Is there a chain on your front door?
Yes No
Can you see someone outside the front door without opening it?
Yes No
Is there limited lighting outside your front door?
Yes No
Do you have difficulty using bolts or locks on your door?
Yes No
Do you have difficulties getting to your front door to answer in time?
Yes No
Do you receive any homecare?
Yes No
Are you seeing an Occupational Therapist or Another Service?
Yes No
Are you concerned about any other risks?
Yes No