BCP HANDYVAN SERVICE
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Householder's Full Name
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Householder's Contact Number
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Householder's Address and Postcode
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Email Address (for Householder or Referrer)
Referrer Name (if applicable)
Referrer Contact Number (if applicable)
Referrer Organisation (if applicable)
Referral Origin
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Self-Referral
Family/Friend
External Agency
Brief description of works required
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I/We can confirm that the referred client is aged over 60 or has a disability or a long term condition and they are in receipt of certain government benefits
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I/We can confirm the referred client consents to have their details shared with 24-7 Locks in order for us to contact them.
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