Private Rental Tenancy Support

Are you contacting us for?...*

Myself

Someone else

By completing this form you are confirming you consent for the information supplied to be used and stored by DENS in line with our privacy policy*

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Have you ever used a Foodbank?*

Yes

No

By completing this form on behalf of another person you are confirming they have given you permission to pass on their information and that they are aware these will be stored by DENS in line with our privacy policy*

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Are you a DENS employee?*

Yes

No

How did you hear about us?

Where was it?

Which one?

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DENS employee details

Email address*

Referrer details

Name*

First Last

Organisation name*

Job title*

Contact number*

Email address*

Client details

Name*

First Last

Contact number*

Email address

Do you live in the borough of Dacorum?*

Yes

Please note that clients living outside of Dacorum are ineligible for DENS' services

Are you over the age of 18?*

Yes

Please note that clients under the age of 18 are ineligible for DENS' services

What would you like our support with?*

Tick all that apply

Benefits

Budgeting

Consumer issues

Debt

Private rental accommodation

Utilities and other bills

Is there any additional information we need to know?

Private Rental Tenancy Support

Our free services include…