Mobility scooter registration in supported housing

Your full nameYou need to tell us your name

Select the property you live inButler House, St GeorgeButterworth Court, Inns CourtChichester House, St Anne'sCondor House, LockleazeField View, EastonHaweswater, SouthmeadJim O'Neill House, ShirehamptonPadmore Court, RedfieldParbrook Court, WhitchurchRosevear, NewtownStudland Court, HenleazeYou need to tell us which property you live in

What floor are you on? For example; ground floor, first floor, etc.

Phone numberYou need to tell us your phone number

Email address

What type of mobility scooter do you have?Class 2Smaller, lighter scooters designed primarily for use on pavementsClass 3Can be used on roads and must be registered with the DVLAMissing or incorrect value

Are you able to leave your home without the use of a mobility scooter?YesNo

Are you on a waiting list to use the storage at the facility?YesNo

Do you use the storage provided at the facility?YesNo

Do you have insurance for the mobility scooter? (We may ask for a copy of your insurance document)YesNo

Is your scooter serviced regularly?YesNo

Would you like to apply for storage for your mobility scooter?YesNo

Read our privacy statement and our Housing Service privacy statement to see what we do with your personal information.

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Mobility scooter registration in supported housing

Mobility scooter registration in supported housing