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First name
Surname
Email
Mobile number
Address:
Post Code
What problem(s) do you have?
Mould
Damp
Leaks infestation
Cracks
Subsidence
Boiler
Others
Who is your landlord?
Council
Housing Association
Private landlord
Name of your Landlord
When did you first tell your landlord about the problems?
Do you still rent the property?
Yes
No
Has the problem been fixed?
Yes
No
Do you have any images?
Have you made any previous claims against your landlord?
Yes
No
Are you in any rent arrears?
Yes
No
Submit
