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LEAP Home Visit
Please fill out your contact details below. You will then receive a call from the LEAP team (this will be from a mainland number) to check your eligibility and arrange a date and time for your home visit.
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Full Name
*
Your answer
Address Line 1
*
Your answer
Address Line 2 (Optional)
Your answer
Town
*
Your answer
Postcode
*
Your answer
Phone Number
*
Your answer
Email Address
Your answer
Eligibility - please tick the boxes that apply to your household.
*
Receive Universal Credit
Receive Housing Benefit
Low income (less than £31,000)
Receive an Income OR Disability related benefit
Required
It would be really useful to understand what areas you hope we can help with.
High Energy Bills
Draughts, damp or condensation
Energy debt
Cold home
Grants or funding
Heating problems
Landlord problems
White goods
Smart meter advice
Problems with my energy supplier
Other:
Other information
Your answer
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