Request homelessness support for yourself

Fair Processing Notice
To find out how we will process and use personal information in connection with this request please see our Privacy Statements.

Below you can find links to more information on resources / support that may be able to help you. If you still wish to make a request for a service, you can apply online using online form below.

Support for Housing issues / Homelessness

Support for adults / older people

Support for children, young people and families

Children and family information

Useful financial support

Is your request urgent?
If your request is urgent or relates to an adult or child protection concern or someone at risk, then during office hours you should phone 0141 287 0555.
Outwith office hours, please phone 0300 343 1505.
About you
1. Name*
2. Surname*
3. Preferred Name
4. Date of Birth*
5. National Insurance Number
6. Address*
7. City
8. Postcode
9. Is there any additional information we need to know about the property?
10. Please tell us how you would prefer us to contact you?
  
  Phone
  
  Email
  
  Letter
11. Phone number (no spaces)*
12. Email Address*
  Please tell us your email address - if you do not have one, then type N/R (for Not Relevant) in the box
13. Gender - If you wish to tell us your gender, please choose from below
14. To follow up your request, we may need to contact you. Is there anything we need to know in terms of your language requirements
15. CHI number (this is your 10 digit Community Health Index number)
16. Immigration Status (if relevant)
17. Next of Kin
18. Next of Kin Address
19. Next of Kin Phone
20. How is your Next of Kin related to you?
21. In addition to the yourself, is there anyone else in your family who should be included in this referral?
  
  Yes
  
  No
22. How many family members should be included in this referral?
  
  1
  
  2
  
  3
  
  4
  
  5
23. Additional Family Member 1
  
  Name of the family member
  
  Surname of the family member
  
  Family members Date of Birth
  
  Please tell us the family members age if you don't know their DOB
24. Additional Family Member 2
  
  Name of the family member
  
  Surname of the family member
  
  Family members Date of Birth
  
  Please tell us the family members age if you don't know their DOB
25. Additional Family Member 3
  
  Name of the family member
  
  Surname of the family member
  
  Family members Date of Birth
  
  Please tell us the family members age if you don't know their DOB
26. Additional Family Member 4
  
  Name of the family member
  
  Surname of the family member
  
  Family members Date of Birth
  
  Please tell us the family members age if you don't know their DOB
27. Additional Family Member 5
  
  Name of the family member
  
  Surname of the family member
  
  Family members Date of Birth
  
  Please tell us the family members age if you don't know their DOB