The ceiling height is: Standard (requires step ladders) High (requires high ladders) Smooth The ceiling texture is: Textured coating 2 Please provide details about the property: Bungalow House Prefab Maisonette Floor level: Ground First Second Higher than second Flat Floor level: Ground First Second Higher than second Is there a shared entrance to the flats? If yes, please provide details of entry (e.g. door entry system, key, keyfob): Yes No Please state the tenancy type: Social Rented Private Rented Privately owned If rented, please provide details of landlord: Please provide details of any risks accessing the property: (e.g. no lift access, pets in the property): Name and Title Relationship Resident 1 Mobile Contact Details Work e-mail
The ceiling height is: Standard (requires step ladders) High (requires high ladders) The ceiling texture is: Smooth Textured coating 2 Please provide details about the property: Bungalow House Prefab Maisonette Floor level: Ground First Second Higher than second Flat Floor level: Ground First Second Higher than second Is there a shared entrance to the flats? Yes No If yes, please provide details of entry (e.g. door entry system, key, keyfob): Please state the tenancy type: Social Rented Private Rented Privately owned If rented, please provide details of landlord: Please provide details of any risks accessing the property: (e.g. no lift access, pets in the property): Resident 1 Name and Title Relationship Contact Details Mobile Work e-mail
telecare_application_form.docx