Forms home Contact us for housing advice Housing Solutions online contact form Are you threatened with homelessness? What are your housing options? Contact us using this online form. We will aim to respond to queries within 10 working days of receiving the form, Monday to Friday 9am to 5pm. The form will generate a reference number for your records and you will get an email giving you the next steps of the process. Check your spam email folder. If you are homeless and have nowhere to stay tonight, call 0208 708 4002. This is a landline telephone number.TitlePlease selectMsMrsMrMxName* First Last Date of Birth* DD slash MM slash YYYY GenderPlease selectFemaleMaleTransgenderNon BinaryPrefer not to sayOtherOther - please specify National Insurance number Telephone number* Email* Address* Address line 1 Address Line 2 Town Postcode Are you a UK National?* Yes No What is your nationality?* Do you need an interpreter? Yes No What language? What can we help you with?*Please selectFamily or friend can no longer give me a homeEnd of social rented tenancyEnd of private rented tenancy (assured shorthold tenancy)End of private rented tenancy (not assured shorthold tenancy)Domestic abuseRelationship with partner ended (non-violent breakdown)I have to leave Home Office accommodation as asylum supportRacially motivated violence or harassmentOther motivated violence or harassmentLeft institution with no accommodation availableMortgage repossessionProperty disrepairEvicted from supported housingFire or flood / other emergencyLandlord harassmentIllegal evictionSofa surferRough sleepingHave you been asked to leave your home?* Yes No When have you been asked to leave by?*If you are homeless today, call 0208 708 4002. DD slash MM slash YYYY Employment statusPlease selectEmployed full timeEmployed part timeUnemployedStudentRetiredDo you have any medical conditions? Yes No Medical conditionsPlease selectPhysical disabilityMental healthLong term medical conditionAre there any other people in your household? Yes No People in your householdClick on 'add household member' to tell us about the people in your household. Click on 'submit' when you have finished. Household member 1 Date of birth Gender Relationship to applicant Household member 2 Date of birth Gender Relationship to applicant Household member 3 Date of birth Gender Relationship to applicant Household member 4 Date of birth Gender Relationship to applicant Household member 5 Date of birth Gender Relationship to applicant Household member 6 Date of birth Gender Relationship to applicant Actions Edit Delete There are no household members. Add household member Maximum number of household members reached. Additional information*Tell us anything else that we should know about your situationDid you have help with completing this form? Yes No Who helped you to complete the form? Redbridge Council is committed to processing all personal information securely and in accordance with current data protection legislation. Further information on how we process your data can be found on our website or you can write to our Information Governance Team at data.protection@redbridge.gov.uk
