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Independent Living Referral Form
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must be completed
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If your enquiry relates to a person under 18 years old you must contact Norfolk County Council on 0344 800 8020, who will process your enquiry in the first instance.
South Norfolk Council takes your privacy very seriously. Under data protection legislation we lawfully process your personal information with your consent.
What we do with your data
The data provided by you will be used by South Norfolk Council (Early Help Hub) for the purpose of administering your independent living enquiry, carrying out evaluation and service reviews. Your data will be stored securely in written/electronic form on the South Norfolk Council system and with your consent (as below) shared with Norfolk County Council. Your data will be kept for 10 years as per the requirements of the Disabled Facilities Grant (DFG) loan.
We will contact other South Norfolk Council departments to check any benefit information that you provide.
Your information will be passed to South Norfolk Integrated Housing Adaptation Team (IHAT), a service delivered by South Norfolk Council and Norfolk County Council to carry out further assessment.
Yes, I am happy for South Norfolk Council to pass my details to the IHAT team and to Norfolk County Council to provide me with an independent living service.
Subject to further assessment and eligibility you may be able to access a service to carry out adaptations to your home. In carrying out these adaptations we could arrange for other independent tradespersons (who have been vetted through either Norfolk County Council or South Norfolk Council) to carry out the work. If you would like us to do this for you, please indicate below that you are happy for us to share your personal details with external tradespersons and other South Norfolk Council departments.
Yes, I am happy for South Norfolk Council to share the details of work required and my contact details with independent tradespersons
I understand that if I change my mind I can let you know that I no longer want this service.
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