Falls Prevention Scheme

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About this form

If you are worried about falling in your own home, or sometimes feel unsteady on your feet at home, we are offering free home safety visits to residents in a number of York Wards who want practical help and advice to reduce the risk of falls in their home.

Residents of the following wards can use this form to request a falls prevention assessment:

Your security and privacy

Please do not use this form to send anything of a confidential nature, for example your credit card or bank details.

We do not rent, sell or trade your personal information; please see our privacy statement.

*Please note: our system will 'time out' after 10 minutes, so for longer messages you may need to compose your feedback before starting this form. You can then 'paste' your text into this form once you're ready to send it.