Application Form for Housing & Support

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Please answer all the questions as honestly as possible to enable us to help you as much as possible with your application for housing and support.

Who is filling in this form?

Checkboxes

1: About You

Personal Information

Full Name
Address
Do you need an interpreter?

2: Supporting Organisation/ Referrer

If you are an organisation supporting this application, please complete the following section:

Name Person Completing this Section
Address
Are you completing this whole form on behalf of the applicant?

2: Supporting Organisation (continued)

Clear Signature
For the applicant: Is it ok for us to contact this person/organisation?

3: Homelessness

Which areas do you think you need support to enable you to keep your tenancy, keep safe and lead the life you want: please tick as appropriate:
Have you had your own tenancy before?
Please tick any or all boxes – which type of accommodation would be most suitable:

Safety/ Risk Assessment

Verbal aggression?
Domestic violence?
Physical Abuse?
Mental Health Disorders?
Drug/ Alcohol Abuse?
Trafficking and Exploitation?
Offending?
Financial Abuse?
Any other type of abuse?

Affordability

This is to help work out if you can afford our accommodation:

Accessibility

Please sign to say that you agree that this information is true and accurate:

Full name of applicant:

Date:

Clear Signature

Thank you for your application.

Application process

After submitting a housing application to Oak Care Home, the team will review your details, conduct a personal assessment, and develop a tailored care plan. Healthcare professionals will evaluate and finalise the plan with your feedback. They will support your transition and regularly update the plan to meet your evolving needs, ensuring personalised and comprehensive care.