Ph076 2026

1. Click ‘Get Form’ to open the Housing Assistance Referral Form in the editor.
2. Begin by entering the customer's details, including their full name and date of birth in the designated fields.
3. Proceed to question Q1, where you will indicate if any information could be prejudicial to the customer’s health. Select 'Yes' or 'No' and provide details if applicable.
4. In Q2, specify how long the customer has been under your care and describe the assistance you provide.
5. For Q3 and Q4, input the current living situation of the customer and whether you have seen their property recently.
6. Continue through questions Q5 to Q14, providing detailed responses regarding housing issues, assistance received, and any other relevant comments.
7. Finally, complete the form by signing it and adding your contact information before submitting it back to your nearest Housing Service Centre.

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