Equipment, adaptations and mobility assessment
If you are disabled or have a health condition that affects your mobility, you may find it difficult to access or use your home safely.
This assessment will identify whether changes can be made to your home to make it easier for you to get around.
We can also provide equipment to help you with important daily tasks you are struggling with.
- The assessment will take about 30 minutes to complete.
- You'll need to register using an email address. This will allow you to save your form and come back to it at any time.
What do I need to tell you?
The form asks questions about your situation. Use the free text boxes to give full details of what you can and cannot manage.
Next steps
Once you have submitted the form, you will receive an email confirmation. We will review your information and get in touch by phone or email.
This form is the start of the assessment process. It will help us to work with you to find out what support you might need.
Further information
More information is on our website: Support to stay at home (opens in new tab)