Applying for yourself
Please read the below information carefully before completing the application form
In order to qualify for a new appliance, you will need to confirm the following:
that you receive certain means-tested benefits. Please note you will have to upload a photo of a benefits statement that is less than 18 months old and ensure that it is in the same name as the applicant
that you have an existing appliance to be replaced. Please note that this will be removed and disposed of at the same time that your new appliance is professionally installed.
If the above applies to you, please complete the application form below.