Are you a referring agency?

• Aged 60 and over;
• Have limited mobility;
• Be an oxygen user;
• Have a sensory need (hearing and/ or sight);
• Have a hoarded home;
• Confined to the bed;
• Have a learning disability;
• Be living with a mental illness;
• Have Dementia;
• Use Dialysis.

• Have a drug or alcohol dependency;
• Have emollient creams applied to your skin;
• Have mental health needs;
• Are a smoker;
• Are living alone;
• Have no smoke detection or have had a previous fire.
• In certain circumstances where no consent has been gained, such as a best interest decision. Please be aware that under the Fire and Rescue Services Act 2004 in this situation we have no powers of entry.

On receipt of a referral RBFRS will attempt to make direct contact with either the individual or the best person to support and facilitate the visit (or joint visit nominee as appropriate).  

If the individual does not qualify for a free Safe and Well visit, please see the fire safety information and advice that is available on our Safety at Home page or use the email below to contact us. 

We will contact you if:

• we need more information or the form is incomplete
• the visit is declined
• we cannot contact the individual or facilitating person we will pass this information back to the referring agency.

If you experience difficulty completing the referral form, or have any questions about our Safe and Well visit service, please either contact us on: 

• Freephone 0800 587 6679 between 9am and 5pm Monday to Friday or use the answerphone available outside of these times
• Email SafeandWell@rbfrs.co.uk

Have you and your colleagues attended our free training At Risk Programme?  This is offered to those who provide care in the community and is designed to increase awareness of the risk of fire to the most vulnerable people. 

To support partners to keep a record of the work being carried out, we have included the option to save a copy of the form. The instructions to do this are at the end of the form when it is submitted.