Book a safety visitWe offer Home Safety Checks to people who are considered to be particularly at risk of fire.During a visit, firefighters or community safety staff will give you advice on how to make your home safer, what to do in the event of a fire and what to do if you are trapped by a fire. They will also fit free smoke alarms if a home is without one and explain how to keep them working.To contact us about booking a visit, please complete the short form below. If you qualify for a visit, a member of our team will be in touch to arrange this Otherwise, you will find some useful information on carrying out your own check here.Advice for Landlords here The form below collects some personal information, which we will only use for the purposes described. You can find out more about how we collect and store personal information hereIf you are contacting us from a partner organisation, please do not use this form to make a referral.Home Safety Check pre-assessment To continue to reduce house fires, deaths and injuries we believe we need to become even more targeted in the way we deliver our safety work.To achieve this, we have changed our Home Safety Check service so that safety advice continues to be given to tall, but home visits by fire service staff are only offered for free to those most at risk of fire.Please answer some questions below to help us determine your likely risk of fire.Name* First Last Please give a full name (no initials)Address* Address Line 2 Town Post code Please provide as full and accurate address as you canWhat are the tenancy arrangements at this property?*Privately ownedRented from a local authority landlordRented from a private landlordNot sureThis question is about who owns the propertyDo you have working smoke alarms?*YesNoCan we contact you in the future? Please select all that apply Email PhoneWe would like to contact you from time to time about our latest safety campaigns or to remind you to test your smoke alarms. If you are happy for us to contact you, please select all methods that apply.Phone*Email Age*6 to 1718 to 2425 to 4950 to 6465 or overAre you contacting us about a faulty alarm?*YesNoAre there any children under 5 in your property?*YesNoDo you live alone?YesNoAre there 6 or more people living at the property?*YesNoIs anyone in the property hearing impaired?*YesNoDoes anyone in the property have a disability, cognitive impairment or mental health needs?*YesNoThis could include things like sight loss, dementia, memory loss or any physical or learning disabilityDoes anyone in the property smoke?*YesNoDoes anyone in the property have alcohol or other substance dependency?*YesNoWould anyone in the property have difficulty in leaving the property quickly in the event of a fire?*YesNoThis could include mobility issues or drowsiness due to medication - if someone needs a walking aid then they may well have such difficulty. Cluttered walkways can also cause difficulties in escaping in the event of a fireAre you a foster carer or in the process of becoming one?*YesNoDoes anyone in the property have care and support needs?*YesNoThis could be care received from either a family member or a care organisation. Support needs cover needing support with preparing meals and having a cluttered and untidy houseDo you believe you are at risk of arson or a fire-related hate crime?*YesNoPost Custom FieldPost Custom FieldUntitledFirst ChoiceSecond ChoiceThird ChoiceUntitledFirst ChoiceSecond ChoiceThird Choice Share this page: Like this page:Like7+
