Book a home safety visit

Use our online form to register for a home safety visit.

After you've submitted your request, a member of our team will give you a call to arrange a time that's convenient for you. If you'd prefer to phone us then please give us a call on 0800 05 02 999.

In the event of a fire or if your carbon monoxide alarm is sounding, please call 999.

Internet Explorer

Guidance for people using Internet Explorer
Dark

If you are using Internet Explorer you may experience issues submitting this form. Please switch to another browser such as Google Chrome, Edge or Firefox.

I would like to express an interest in a home safety visit for:

Your contact details

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

Your agency details

Your relationship to the person


Please let us know the relationship to the person you are referring.
Relationship to the person being referred

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?
Please provide contact details 

About the household

Please provide as much information about the household as you can. 
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 or mobility issues
Someone in the property has sensory loss (vision, hearing etc)
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
None of the above

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.
How did you hear about our home safety visits?
By completing this form I give consent to Devon and Somerset Fire and Rescue Service to contact me for the purposes of booking a home safety visit for myself, a family member or person in my community. 

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.