Willow Housing - Accommodation Enquiry Form 🏠
Thank you for your enquiry. Please complete this short form and a member of our team will contact you within one working day.
Full Name
*
Contact Number
*
How old are you?
*
Which town do you currently live in?
*
Our accommodation is based in Birmingham. Are you able to live here?
*
Yes
Not sure - I'd like to discuss
No
Which benefits do you currently receive?
*
Universal Credit
Personal Independence Payment (PIP)
Housing Benefit
Other
What is your current living situation?
*
Living with family/friends
Private rented accommodation
Supported accommodation
Sofa surfing
Homeless
Other
What support would you benefit from?
*
Mental health support
Physical health support
Housing support
Substance misuse support
Other
When are you looking to move?
*
ASAP
Within a week
Just looking at the moment
Other
Best time for us to call you? We will aim to call you on the same day or next working day.
*
9am-11am
11am-1pm
1pm-3pm
3pm-5pm
5pm-7pm
Anytime
Other
Submit
Should be Empty: