A fair and equal service

Online form

We want to treat you and all other tenants fairly and with respect.

So we are asking every tenant to tell us about themselves and how they want to be treated.

By answering a few simple questions you can help us give you a fair and equal service. And you could win stylish improvements to your home!

The information you give us is confidential. We will only share your answers in the 'communication needs' section with our front-line staff to help us give you a better service. It's as simple as that.

You don't have to answer all the questions, but the more you do, the better we can make our service to you.

Please do not send more than one form; we can only accept one entry from each tenant.

Many Thanks!

YOUR DETAILS * You cannot leave these parts blank

help  *
(if none, put 'none') *
If you want us to contact you this way.

Ethnicity Please tell us your ethnic background.


Asian or Asian British

(please state)
Black or Black British

(please state)
Other ethnic background

Do you consider yourself to be a refugee?




Disability A disability is a physical or mental impairment that has a significant and long-term effect on a person's ability to carry out daily activities.

Do you consider yourself disabled?

If 'Yes': to help us give you a fair and accessible service, please tell us the nature of your disability:

Communication needs Different people need different types of communication. For example, people with a visual impairment may need letters in large print. Or you may want to have another person there when we are doing work in your home.
Please fill in this section if you think we need to consider your individual needs when we contact you in future.

When we write to you
If you have difficulty reading English, or you would like information in another way, please tell us how you would like it.

When we phone you
Would you like us to use:

If no-one in your house speaks English we can get an interpreter to translate the call. Which language do you speak?

When we visit you
Is there anything we should know?

Thank you for your answers. You may want to check them before you send the form. Good luck in the prize draw!


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Data Protection

The information you supply on this form will be sent to Northwards Housing. It will only be used to process your request for information or the service(s) described on this page. Any details you supply will be treated confidentially and will only be used in direct relation to work needed to carry out your request.

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