Aids and adaptations enquiry form

If you need aids or adaptations to help you live independently in your Futures home, or want to request help for a Futures customer, please fill out this form with details of the changes you would like.

You can request up to two types of aid or adaptation on the form. If you need more - please fill out the form again with further details.

Please provide as much detail as possible. This will help our team to understand what support you need. We will be in touch once we have reviewed your application.

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 *

Where do you need lever taps installing?

Where do you need a key safe fitting?

Do you have another aids or adaptation request? *

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?

Where do these additional lever taps need fitting? *

Where does this additional key safe need fitting? *

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 *

Aids and adaptations enquiry form

Let us know if you need aids and adaptations to live independently in your home.