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Handy Person Service - Referral Form
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* Indicates required question
Have you / the tenant used the service before?
*
Yes
Don't know
Option 3
Eligibility
Over 60
Disability
Health
Other Vulnerability
First Name:
*
Your answer
Surname:
*
Your answer
Age:
*
Choose
Under 20
20-29
40-49
50-59
60-69
70-79
80-89
90-99
Gender:
Female
Male
Transmale
Transfemale
Prefer not to say
Other:
Clear selection
Address 1
Flat position if applicable
Your answer
Address 2
*
House number & Street
Your answer
Area:
*
Choose
Glasgow City
North Lanarkshire
South Lanarkshire
North Ayrshire
East Ayrshire
South Ayrshire
Postcode:
*
Your answer
What kind of job do you/the tenant require?
Replacing curtain rails/poles/blinds
Replacing high or awkward light bulbs
Fitting light shades
Hanging mirrors/pictures
Moving furniture
Assembling flatpack furniture
Assist in clearing out property
Ease sticking doors
Minor joinery work
Minor garden maintenance
Painting (1 room)
Wallpapering (1 wall)
Other:
Contact phone number:
Your answer
Where did you find out about this service?
Used before
Staff Member
Westworld
Leaflet
Social Media
Website
Other:
Clear selection
Are you a WSHA tenant or are you completing on behalf of a WSHA tenant?
I am a WSHA tenant
I am completing on behalf of a WSHA tenant
Clear selection
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