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Adviceline
Contact Adviceline Mon to Fri 9.30am – 2.30pm
0344 848 7919
Freephone:
08082787897
Citizens Advice Bath & North East Somerset
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Benefits and debt client referral form
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What does your client require help with?
*
Help To Claim Universal Credit
Debt
Mind clients for Polly
Client name
Please choose...
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Prof.
Rev.
Client date of birth
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Client address
*
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
If your client has no fixed abode, please enter 'No fixed abode' in the House name/number fields, 'BANES' in the City and County fields, and 000000 for the postcode
Please tick all the ways the client is happy to be contacted by us?
*
Phone
Voicemail
Text
Email
Letter
Please tick as many as possible to make it easier for us to support you. If they have no fixed abode, please ensure that we have at least 1 way of contacting them other than by letter.
Client phone number
*
Client email
*
Email
Confirm Email
Your name
*
First
Last
Your organisation
*
Your phone number
*
Please give us as much background as possible to help us when we contact the client
Data protection
*
Please tick this box if your client has consented to being contacted by Citizens Advice - Bath & North East Somerset
We keep client details on our database which is confidential to Citizens Advice. The details we take are to enable us to give clients the appropriate advice. They aren’t accessed by anyone else except in the case of gathering feedback on our service which is also done confidentially. We don’t sell client data to anyone.
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Benefits and debt client referral form
Benefits and debt client referral form
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