Apply for an Adult Changing Places Key

 

Carer's Details

 

I have been trained in the use of equipment inside the Changing Place facility and I have read and understood the guidance.

Agree *
 
 
 
 
Do you live in the Chelmsford City Council area? *
Do you live in the Chelmsford City Council area?
 
 
 
 

User's Details

 
 
Is the address of the user the same as the carer?
Is the address of the user the same as the carer?
 
Does the user give consent for their benefit information to be held by Chelmsford City Council? *
Does the user give consent for their benefit information to be held by Chelmsford City Council?
 
 

Evidence

 

Changing Places facilities are only available to people receiving the higher rate Disability Living Allowance. Please therefore attached scanned evidence of your eligibility.

If you do not have evidence in electronic format, please send it to us by post, quoting your form reference number, which will be sent to you by email when you submit this form.

 
 
 
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