Enquiry form

Name*
Title First Last
Date of birth*
Address*
House name/number Street/Road City County / State / Region ZIP / Postal Code Country
Daytime telephone number
Email
Do you give us permission to send you a text or leave a voicemail?
Please provide a telephone number or email address so that we can contact you.
When are you NOT available?*
Our service operates from 9.30am to 1.30pm Mon - Fri. Please tell us if you are NOT available during any of these times so we can make an appointment to call you at a time that suits you?
Have you contacted us before?
- Yes
- No
I am requesting advice about:*
How did the issue arise?
What have you done so far?
What would you like us to do for you?
Is there a deadline you must meet?
Date Format: DD slash MM slash YYYY
More about yourself...
How would you describe yourself?
Do you have any disability or health problem?
Data Protection*
We keep your details on our database which is confidential to Citizens Advice. The details we take are to enable us to give you 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 your data to anyone. Is that okay with you?
- I agree to Citizens Adivce - Bath & North East Somerset storing and using information about me

Citizens Advice Bath & North East Somerset