Online Enquiry Form for Residents of Rossendale & Hyndburn and referring agencies
***COVID 19: We have a limited number of face-to-face appointments and can arrange this is we cannot help you by phone or email.. We are continuing to deliver telephone and email advice and are also piloting remote appointments via video call.***

We aim to respond to your enquiry within five working days. If you enquiry is urgent, please call our Adviceline on 0808 278 7975 (Monday to Friday 9.00 am - 5.00 pm).

If you live outside the boroughs of Rossendale & Hyndburn, please check for your local office.

Residents of Blackburn & Darwen should contact Lancashire West Citizens Advice -
Sign in to Google to save your progress. Learn more
Date *
If you are completing this form on behalf of another person, please provide your name, agency and contact details.
If you are completing this form on behalf of another person, please also confirm that they have consented for us to record the details of this referral and to contact them.
Clear selection
Name of person needing advice *
Post code *
House number *
Phone number/s *
Can we text you? *
Can we leave a message? *
E-mail address *
Confirm E-mail address *
Can we email you? *
We need to record information about you to help with your enquiry and have a legitimate interest to do this. For more information about our Privacy Policy, see - Please confirm that you have read our Privacy Policy. *
We need your consent to record and use your special category personal data We need your explicit consent to use some information. If you agree, we’ll use this information, which is known as ‘special category personal data’ to: give you advice; help us gather data to improve our service; support our research in a way that you can’t be identified. We’ll make sure all your information is kept safe in our secure case management system. By ticking the boxes below you consent to Citizens Advice recording the special category personal data you choose to provide Citizens Advice. Yes, I consent to you holding information on my (please tick all of those you agree to, particularly if it relates to your enquiry) *
Please let us know what your enquiry is about: *
Please provide brief details about your enquiry, eg, relevant dates/time limits, type of housing, health issues, etc, as appropriate. *
Clear form
Never submit passwords through Google Forms.
This form was created inside of