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HOUSING 
This form is for non-emergency repairs ONLY. To report an emergency repair, please call Rotherham Connect on (01709) 336009.
Please note that all fields marked with an * on the form must be completed before clicking the 'Submit' button. Please allow 5 working days for a written repairs receipt and be aware that some type of work may not require an appointment.
Reference Number: 1TPTFQ555937
* Your neighbourhood office:  
* Name:  
* Address:   Address Line 1
  Address Line 2
  Town / City
  County
  Postcode  
* Telephone Number:    
Mobile Number:  
Email Address:  
* Type of repair:    

* Give details of your requirements: (e.g. sink tap in bathroom is leaking)

  

When will you be available? Please note: All morning appointments will be between 8:00am and 12:00pm. All afternoon appointments will be between 12:00pm and 4:00pm

 

AM

PM

Monday:

 

 

Tuesday:

 

Wednesday:

 

 

Thursday:

 

 

Friday:

 

 

Additional Access Required
i.e. Phone 30 minutes before arrival, or knock loud due to hearing difficulties

Are the keys to be collected from another person living nearby?
Before you submit your Request for Repair we would appreciate it if you could give us feedback on the way this service is provided by answering the following three questions in order to improve our service delivery to you.
Customer Satisfaction - Strictly Confidential: By answering the following questions, you will help us make sure we give a good and fair service to all the people in the community.
Are you happy with the choices you have for reporting a repair?
Do you feel that there are any barriers when reporting your repair?
How would you like to improve the choices that are available to you?
Equalities Monitoring -  Strictly Confidential: By answering the following questions, you will help us make sure we give a good and fair service to all the people in the community.
Gender:
Do you have a disability?
What is your ethnic origin?