Request a visit for someone else

Request a visit for someone else

Your details

An email address we can get back to you on
A telephone number we can contact you on
Please provide the full address including postcode
Consent(Required)
Is the person aware that you are contacting us on their behalf?

Details about the person you are making this request for

An email address we can get back to you on
A telephone number we can contact you on
Their age(Required)
Please select the option that applies to their age
Who should we contact(Required)
If we are unable to contact the nominated person by telephone to arrange a visit we will contact them by email if an email address has been provided.

More about the recipient

Their circumstances
To enable us to prioritise your request and tailor our visit to the recipient’s needs, please let us know if any of the following criteria apply to their circumstances. Please select any of those that apply, and provide additional information in the box below.
Is there any other reason you may be at risk of having a fire in your home?
Have you received a leaflet with a promotion code?
Page last updated