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Report issues with a private landlord

Please only complete this form if you have already approached your Landlord/Agent, and given them reasonable time to deal with your complaint.

Unfortunately, if you have not reported your concerns in the first instance, this will delay the help we can give you.

Person making the referral
Given name(s)
Family name
The telephone number we can contact you on.
If you don't have an email address, please type n/a
Occupiers details
Given name(s)
Family name
If you don't have one, please type n/a
Please confirm if you would be happy to receive correspondence relating to this matter at the above e-mail address rather than via post



Issues information
Have you made your landlord aware of the issues?

It is important that your landlord is made aware of the items of disrepair and given the opportunity to address them. If you have not already reported the issues to your landlord, you must do so prior to submitting this complaint. A template letter to report disrepair issues to your landlord is available on our web page.

Have you reported the problem to your landlord?


How did you report the problem to your landlord?





Please state how you have reported the issues to your landlord.
Accommodation details
What type of property do you live in?











Please give details.
Do you share the house where you live with other households? i.e., people who are not related to you


What type of problems are you having?
Please select the issue(s) you are having:














Do you have an Energy Performance Certificate (EPC)?



Do you have a Gas Safety Certificate?



Do you have an Electrical Safety Certificate?



Do you have a Tenancy Agreement?



Do you claim Housing Benefit?


Are you in rent arrears?


Have you been served notice?


Are you on the Housing Waiting List?


Does anyone in the property have a disability or illness that you feel we should be aware of?


Do you have any support from other agencies such as Framework/Social care


Your Landlords details
Your Agents details
Contact consent
Do you consent with us contacting your agent and landlord or other agencies to help resolve you complaint?


Data consent
Consent for storing submitted data