Please download the Medical Form (pdf 53 kB)
When completed, please send it with your evidence to email@example.com
If you or someone in your household has an illness or disability which is affected by your current accommodation, we ask you to complete a Medical Questionnaire.
Before you complete your questionnaire, please make sure you understand the following:
Aids/adaptations: If you require aids or adaptations in your current or new home, please tick the boxes for the aids you require. If you need an Occupational Therapist to assess what aids you need, please identify this need on the questionnaire.
Should you require an adapted property, a Housing Occupational Therapist will need to complete an assessment with your household. Solihull Community Housing reserves the right to direct offer adapted properties to customers who best match their needs as per our Allocations Policy.
What happens once you submit your Medical Questionnaire:
Our staff will assess the questionnaire with any supporting information you provide. Examples of supporting information are a statement from your general practitioner, hospital consultant, or occupational therapist.
When you have returned your questionnaire to us, we will assess the information you have provided with our professional Medical Advisors. We make the assessment based upon the impact your current housing circumstances have on your health, or the health of any other member of your household.
We then decide whether the overall impact on the household, or anyone living in the household, is severe enough to give you another priority on medical grounds.
There are three categories of medical need:
Exceptional medical need
This will be decided where you or a member of the household has a life threatening condition, which is seriously affected by their current housing. This will be reviewed after 6 months.
Urgent medical need
This will be decided where your current housing conditions are having a major effect on the medical condition of you or a member of the household. This will be reviewed after 12 months.
Non urgent medical need
This will be decided where your current housing conditions are having a minor effect on the medical condition of you or a member of the household.
These categories are prioritised in with the banding system described in Prioritising Applications, here.
Please note, we now only accept medical forms that are completed online.
We are currently experiencing high demand for medical and occupational therapy assessments. We are working to process these as soon as possible but due to the high levels an assessment may take up to 12 weeks to complete.
We aim to process your Medical Questionnaire within twelve weeks however this may be delayed if we do not receive the required evidence in order for us to process your Medical form.
What is required?
In order for us to process your Medical Form you will need to provide the following evidence:
- Confirmation of diagnosis
- Confirmation of any treatment
- Confirmation of any Medical related benefits (DLA/PIP/ESA/Carers Allowance)
We require a letter from your GP, Consultant or Occupational Therapist outlining the above information and your need to move based on health reasons. All evidence must be dated within three months. Failure to provide evidence could result in us not processing your Medical form.