We are asking for this information so that we can accurately assess your housing needs. If you do not provide this information, your application for tenancy with Urban Plus may be at risk.
You must provide supporting information from your doctor (eg. a medical certificate) or your support worker if you have one.
Please fill out this section on behalf of you and any other person that will be living with you.
I/we declare that the information contained in this application is true and correct to the best of my/our knowledge and acknowledge the right of Urban Plus Ltd ("Urban Plus") to check the validity of the information supplied including medical information from my doctor or key worker if applicable. If misleading or false information is provided, this application may be cancelled.
I/we acknowledge that: