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Fill in the short form below to get started. There’s only a few steps and will take less than a minute to complete.
Full Name
Phone Number
Email
Address
Post Code
Benefits (Please indicate all benefits you or someone in your household currently claim)
Universal Credit
Child Benefit
Working Tax Credit
Pension Credit Guarantee
Employment and Support Allowance (ESA)
Income-based Jobseeker's Allowance (JSA)
Income Support
Child Tax Credits
Housing Benefit
Pension Savings Credit Benefits
LA flex - (household income below £31,000 or health conditions )
Other
What type of Boiler do you have?
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Combination Boiler
System Boiler with Hot Water Tank
Back Boiler behind Fireplace
Don’t know
What is your current heating system?
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Gas Boiler connected to wall radiators
Electric room / storage heaters
Warm air system
Gas room heaters
No heating at all
Other / Not sure
Who owns the property?
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Myself
Family Member
Landlord
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