Torbay Council - Health & Social Services - Social Care Information Request

Torbay Council

Health & Social Service

Social Care Information Request

Contact and Assessment Team
Union House
Union Street
Torquay TQ1 3YA

Telephone: 01803 208500
TextPhone: 01803 208383

This e-form enables you to request information from Adult Services. We will provide advice and information to everyone, however services are only provided to those who have the greatest need after an assessment is made.

This e-form enables you to request information from Adult Services. We will provide advice and information to everyone, however services are only provided to those who have the greatest need after an assessment is made.

Please complete all fields marked with an asterisk *

Date:

04/07/2009

First Name *

Surname *

House name/number *

Road *

Village

Town *

County *

Postcode *

Home telephone number *

Can messages be left on an answerphone? *

Yes No

Mobile telephone number

Email address *

Name of GP *

Practice Address *

Your age *

18-64 65+

Best time of day for contact

9-12am 12-3pm After 3pm

Is the care you require for yourself

Yes No

In order that the correct team contacts you, please tick the box(es) that best describe your query

You need further information about the occupational therapy services

You need further information on home care

You need further information about equipment and adaptions to the home

You need further information about community/day centres for Adults

You want information about the Community Alarm Service

You want information about Meals on Wheels

If you have a physical disability please give a brief description of your requirements:
(Please remember we cannot do an assessment of needs without the permission of the individual requiring the service)

If you care for someone, would you like further information about

A carer's assessment

Carer's help and assistance

Respite care

Registering as a carer

If you have any other queries about carers, please give a brief description of your requirements

If your query has not been covered in the above form, please give us more information about your request

Do you need information about direct payments

what these do

Standard e-gov form buttons
Cancel
Cancels the current operation, disregards any changes made to the form and returns you to the Torbay web site

Delete
For a new form, this acts as Cancel. If you are amending an existing form then any data relating to this form is deleted.

Defer
Performs minimal validation of the data in the form, then saves the form WITHOUT requesting it to be processed. You can return to the form at a later date to complete it.

Process
Only press this button if you are in agreement with and declaration or conditions specified on the form.
Pressing this button performs full validation of the data in the form, then saves the form, requesting it to be processed. You can only return to the form to amend data if processing of the form has not already started.