Adaptations enquiry form - Futures Housing Group

Sometimes it only takes small changes to help you continue living independently when life gets more challenging. There are lots of ways in which we can help.

Fill out this form to tell us what home adaptations you think you need. We will review your application and get back to you as soon as we can.

If the changes are outside the scope of what Futures can do to help, we can also put you in touch with other organisations such as your local council that can help.

Main questions

Who is the aids or adaptations request for? *

What type of aid or adaptation do you need? *

Where in the property are these aids or adaptations needed *

Lever tap location

Where do you need lever taps installing?

Key safe location

Where do you need a key safe fitting?

Further adaptations needed

Do you have another aids or adaptation request? *

Further adaptations detail

What other aid or adaptation do you need? *

Where in the property is this second aid or adaptation needed? *

Is there any more information about this second aid or adaptation you would like to share with us?

Second lever taps

Where do these additional lever taps need fitting? *

Second key safe

Where does this additional key safe need fitting? *

Customer details

Your first name *

Your last name *

What is the address of the property where these aids or adaptations are needed *

Your contact telephone number *

Your email address

Is there any extra information about this request that you think we need to know?

If you have photographs or documents that will help to explain the aids and adaptations you need, please upload them here.

No files selected

Security check *

To find out about how we manage your personal data, take a look at our privacy notice.

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