Energise Sussex Coast Referral form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Important message regarding fuel vouchers

We aren't able to issue fuel vouchers without the client having a full energy advice appointment where we look at all the different ways they could save money on their energy costs, this takes about 30 minutes - an hour.

Please make your client aware that you are referring them for an energy advice appointment and not just a fuel voucher.

Current waiting time until first contact = days 1-2 days

Referral organisation

AGE UK

Battle Foodbank

Bexhill Foodbank

BHT

British Red Cross

CGL Substance Misuse

Christians Against Poverty

Eastbourne foodbank

East Sussex County Council

Education Futures Trust

Energy Champions (ESC)

Family Support Work (FSW)

Friend families and travellers

HARC

Hailsham foodbank

Hastings foodbank

Hastings council

HUG

Imago

NHS

Optivo

Osborne Energy

Ovesco

Probation Service

Reed

Retrofit Works

RSI Southdown Housing

Salvation Army

SCDA Newhaven

Self referral

STEPS

St Michael's Hospice

Stroke Association

Wealden District Council

Other:

Clear selection

Referrer's name

Referrer's email

Referrer's phone number

Client name

Client phone number

Client email

Client postcode

This service is currently only available for East Sussex residents

Details of referral

Would you like us to send you a follow up email to let you know how we helped your client?

Due to the very high number of referrals we are receiving currently we are unable to do this as standard so please contact us directly if you require follow up information. Please email kate@energisesussexcoast.co.uk

Yes

Clear selection

Thank you!

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms