Believing in accessibility for all

Duty to refer

If you are a specified public body, you can use this form to refer consenting people who you believe to be homeless or threatened with homelessness. If you have any queries, please email

Referring agency details

Enter your full name
Enter a UK landline or mobile number
Enter an email address

The person being referred

Client support needs

How many people are in the household you are referring to us (including the applicant)?

I / we confirm that we are referring the person / household to the City of Wolverhampton Council and Wolverhampton Homes as we believe they are at risk of homelessness and confirm they have given their consent to this referral.
Please tick the box to proceed

Privacy information

The council is under a duty to protect public funds and may use the information held or provided by you for the prevention and detection of fraud. For more information on how we use your data to do this please read our privacy policy.