Please note questions marked with an asterix (*) require an answer
Type of Tenure *
Would you consider yourself to have a disability? *
Do you have a serious, ongoing medical condition? *
Are you known to the Community Mental Health Team? *
Have you been released from a custodial sentence within the last month? *
Are you on a rehabilitation order or probabtion order? *
Are you recently discharged from the Armed Services and/or have you been a member of the Armed Forces? *
Have you ever been in care? *
Are you expecting a baby? *
Have you approached Worcester City Council Homeless or Advice before? *
Are you registered on Home Choice Plus? *
Are you completing this at The Hive? *