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Request a home safety visit

Use our online form to request a home safety visit.

Please note: We can only visit properties with the usual occupants present and cannot accept referrals before hospital discharge or when the occupant is not going to be home for the visit.

If the referral you are making is a genuine risk, or potential risk, to life or property do not use this form.

  • If there's an immediate emergency or risk to life, dial 999 and report it to us.
  • If there is no immediate risk, but a visit is urgently needed, call 0800 05 02 999. Please note, the phone line and email are monitored Monday to Friday, 10am to 4pm.
  • If your carbon monoxide alarm is sounding, call the Gas Emergency Helpline on 0800 111 999.
I would like to express an interest in a home safety visit for:
Please enter your 3-digit reference code or agency name and choose from the displayed options.

Your contact details

Please provide your contact details. You will receive an email confirmation.

The occupier's details

Please provide the main contact details for a person (at the household) that you are referring for a home safety visit.
Title
Who can we contact to arrange the visit?

About the household

Please enter the full postcode and select your address from the dropdown list.
    Is there a working smoke alarm in the property?
    Please tick all that apply
    		Someone in the property is over 85 years old
    		Someone in the property is over 65 years old
    		Someone in the property is under 18 years old
    		Someone in the property is under 12 years old
    		The resident lives alone
    		The property has a thatched roof
    		Someone in the property has a disability
    		Someone in the property has mobility issues that would prevent or slow escape in an emergency
    		Someone in the property has sensory needs (partially sighted, hearing impairment)
    		There is evidence of hoarding or poor housekeeping
    		There are concerns about a resident's mental health
    		Someone in the property is a smoker
    		There are concerns about a resident misusing alcohol
    		There are concerns about a resident using drugs
    		Occupant has previously had a fire or a near miss incident
    		None of the above
    Please state any known risks or concerns about the property and occupants. Include any known risks to the safety of our staff when visiting the property.

    Additional support

    We can provide translation and interpretation for home safety visits. To request this, please select the boxes below:
    Translation requirements
    Please state the languages you would like us to use. We may not be able to provide interpretation for all languages but, we will try to accommodate requests as best as we can.
    Consent

    The person is aware of the referral and has agreed to have a home safety visit.

    Important information

    This form has been designed for collecting data for the purpose of delivering Home Safety Visits. The data is normally kept for six years, however, where we have identified a high safety risk for an individual, we will retain the relevant information for as long as it remains current. The lawful basis for processing the information is necessary to perform a task in the public interest.

    By completing this form, I agree for Devon and Somerset Fire and Rescue Service to make contact for the purposes of booking a home safety visit for myself or someone else.

    For further information on why we collect and use your personal data and your statutory rights relating to personal data, visit the Privacy Notices page.