Submit your own initial contact assessment (adult social care)

You can request an initial contact assessment online either for yourself or for someone else.

Please complete as much of the form as possible. We will try to call you back within 3 working days so please ensure you provide us with your contact details.

This initial assessment is used by us to understand basic information about you or, if filling this in for someone else, the person who needs assistance.

The information you provide will help us to better understand the assistance you may require. After submitting your initial assessment a member of our help desk team will call you to discuss your case further.


Do not use this form if your request is urgent. Instead, call us on: 

  • 01202 123654 during office hours
  • 01202 657279 for out of hours emergencies.

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