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> enquiry-form-for-new-repair
Report a new repair
Sending your details...
Please use this form to report one repair at a time.
Name:
*
Please enter the telephone number of repair reporter:
*
Please enter the telephone number for repair contact / access:
*
Please enter the email address you wish us to use to contact you about the repair:
*
Address:
*
Bedroom number (if applicable):
Postcode:
*
Repair location: Select from below by clicking one item or Use Ctrl + Click to select multiple items
*
Bathroom
Bedroom
Dining room
Outside property
Lounge
Hall
Kitchen
Other (please specify):
Exact location of repair (e.g. ceiling or wall. If fencing, please confirm if front, back, left or right):
*
Description of the repair (Please describe the fault in as much detail as you can):
*
Please add access details and any other notes or information you want us to be aware of:
Are you the tenant or shared owner?
Yes
No
Photos of the damage (up to 10 images):
Send confirmation to emails below (optional)
Enter one or more email addresses, separated by commas. Only Advance staff or direct Support Workers emails should be added to this field.
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