Eligibility assessment

Tell us about your housing repair problems.

This form helps us understand your tenancy, the problems in the property and whether they have already been reported.

Do you currently rent your home?

Yes No

Who provides your home?

What problems are you experiencing? (select all that apply)

Are the problems still happening?

Have you reported the problems?

Have you already made a claim?

Have you instructed a solicitor or claims company?

Postcode

Full name

Phone number

I agree that EasiGo may use the information I provide to review my enquiry and contact me about this housing disrepair assessment. I have read the Privacy Policy.

Please do not include medical records, identification documents or other sensitive files in this form.