Aldwyck Application For Housing Page 5
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20Part 5: medical information
Do you or a permanent member of your household have a long term
Yes
No
medical condition, disability or illness?
Is the medical condition affected by your current housing?
Yes
No
If yes, you can ask for an assessment for extra priority for medical reasons. You should fill in and
return a medical information form which you can obtain from the Customer Service Centre by
phoning 01438 242666, or by downloading a form at
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