ENERGY ADVICE REFERRAL FORM

Need advice on Energy issues?

Struggling to pay your energy bills?

What we do:

Our dedicated Energy Advice team provides one-to-one energy advice appointments to Brent residents who are in or at risk of fuel poverty, often vulnerable and may be struggling to pay their bills. Energy advice includes advice on energy efficiency, income maximisation and energy grants with the aim of reducing their bills.

How to get help:

Contact Citizens Advice Brent using the form below or call 020 8438 1224 to book an appointment with our dedicated Energy Advice team. We aim to get back to you by your preferred contact method within 3 working days.

If you do not live in Brent please contact your local Citizens Advice which you can find  here to get help.

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First Name *

Last Name *

Email address *

First line of your address *

(if a flat, please include the flat and block name/number)

Post Code *

Date of Birth *

In the form dd/mm/yyyy

Phone number *

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Can we leave a voicemail? *

• Yes
• No

Can we send an SMS? *

• Yes
• No

What is your preferred method of contact? *

• Telephone + SMS
• Telephone/Voice Message
• Email

Are you single, married or living with a partner? *

• Single
• Married
• Living with partner
• Other

Are you or your partner (if applicable) working? *

• Full-time
• Part-time
• Not working

Are you/partner (if applicable) claiming benefits? Please provide details *

• Universal Credit
• Other income replacement benefits (eg ESA/JSA/PC/HB)
• Disability related benefits (eg DLA/PIP/AA)
• Not claiming any benefits

Do you rent or own your own home? *

• Rent
• Homeowner
• Other

If you are renting, is your landlord, *

• Housing Association/Council
• Private Landlord
• Not renting

Do you have any savings? *

• Yes
• No

Are you facing a threat of disconnection action in the next 5 working days? *

• Yes
• No

What energy advice do you need? *

• Understanding your energy bills
• Switching energy tariff
• Applying for a Warm Home Discount (WHD)
• Tips and support for improving energy efficiency
• Advice on energy savings measures
• Switching to smart meter
• Getting on your energy supplier ‘Priority Service Register’
• Understanding the support available to maximise your household income and pay your energy bills
• Getting a fuel voucher
• Support with energy grant applications
• Other energy advice-related issues

What more can you tell us about the issue you would like advice on? (Please note maximum 1000 characters limit)

I give permission for Citizens Advice Brent to store and process sensitive personal information about me (without your consent we can only offer limited help) *

• Yes
• No

We will use the information you provide in your enquiry to provide you with advice and to direct you to the right service. By choosing to include any Special Category Data (including but not limited to information about your health, ethnicity or trade union membership) you are consenting to us using this information for this purpose.

For more information about how we use your information, please see our Privacy Policy.

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