Home Risk Assessment

Home Safety Check

Please take a minute to complete our home risk assessment to help ensure a safe and supportive home environment for you and our team during the visit.

Question 1 of 6

Is your house number or property name missing, or hard to see from the street?

Please answer this question.

Question 2 of 6

Is anyone likely to be smoking or drinking alcohol in the home during our visit?

Please answer this question.

Question 3 of 6

Is there known substance use among anyone who may be in the home during our visit?

Please answer this question.

Question 4 of 6

Has anyone in the home been violent or aggressive, or threatened to be?

Please answer this question.

Question 5 of 6

Are there any weapons or firearms in the home?

Please answer this question.

Question 6 of 6

Are there any animals in the home?

Please answer this question.

Finally, please confirm your details

By submitting this form you confirm the information above is accurate to the best of your knowledge, and that you'll arrange anything you've confirmed before our visit.

Please enter your name and relationship to the client.

Thanks for submitting our home risk assessment, we'll be in touch shortly.
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