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Referral Form

This form is for care providers, family members, or professionals referring someone for the benefit of housing with additional support.

Resident Information

Resident name:

Referrer’s name:

Expected residency start date:

Property and room number they are moving into:

Resident Needs

Is the property being considered fully appropriate for the individuals needs?

Yes No

What information (if any) would it be useful for IronOak to know to provide a better service? E.g. if a resident is hard of hearing, has particular triggers to be wary of, etc.

Legal Status if any (e.g. section 25, 117, forensic, or other):

Does the resident have capacity to sign a tenancy agreement?

Yes No

Details of appointee, if relevant (or other professional who can sign tenancy agreement on resident's behalf)

Resident Information

Does this resident have a history of arson, significant property damage, aggression or violence towards others?

Yes No

Is the individual in receipt of DLA?

Yes No

Please confirm rate of DLA

High Medium Low

Is the individual in receipt of PIP

Yes No

Please confirm rate of PIP

High Medium Low

Is the individual in receipt of ESA?

Yes No

Is the individual in receipt or waiting for any other benefits?

Yes No

Please provide benefit details

Does the individual have a job?

Yes No

Please detail the job and hours worked per week

Does the individual have more than £16,000 in their bank account?

Yes No

What is the balance?

Does the individual have any other savings or income? (Stocks, shares, ISA, property)

Yes No

What is the value?

Does the individual have a pension?

Yes No

What is the amount?

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For general enquiries or questions, you can get in touch with us using our contact page.

Resident Application

Apply for non-supported, social housing.

If you do not require support services and are representing yourself, you can apply directly for social housing.