Portal

Luton Borough Council Resident Form

If you or anyone in your household is unable to self-evacuate in an emergency due to limited mobility, visual or hearing impairments, medical conditions, or any other factors that may make it difficult to evacuate quickly, it is crucial that you inform Luton Borough Council so that they can help arrange support. 

Completing the Questionnaire below for everyone within your household will help Luton Borough Council understand whether your household needs this essential support. 

If your Questionnaire indicates that you would benefit from emergency assistance, TEAM Safety Services will then arrange a visit to create a personalised evacuation plan for you. This plan will then be shared with Luton Borough Council to ensure that suitable safety measures are put in place.

If you have any other questions about your home, please contact Luton Borough Council.

Personal Emergency Evacuation Plan Questionnaire

Please complete this questionnaire so that your housing provider can arrange any assistance or support you may need during an emergency evacuation.

Please provide your apartment number here.
Please select your building name or number here.
Do you or anyone in your household have any difficulty noticing or responding to a fire alarm or emergency alert (e.g., due to hearing loss, sensory processing difficulties, or deep sleep patterns)?
Do you or anyone in your household have any difficulty moving quickly to evacuate your home in an emergency?
Do you or anyone in your household use any mobility aids, such as a walking stick, frame, wheelchair, or stairlift?
Are you or anyone in your household able to safely use the stairs in an emergency if the lift is unavailable?
Do you or anyone in your household have a medical condition, health concern, or disability that could affect your ability to leave the building quickly in an emergency?
Do you or anyone in your household have difficulty understanding or remembering emergency instructions?
Do you or anyone in your household have difficulty seeing emergency signs, exit routes, or stairs clearly?
Do you or anyone in your household have a carer, support worker, or family member who assists you at home?
Would you or anyone in your household like to be contacted to discuss emergency evacuation support options?
In the box below, please describe the issue or defect related to your flat front door, or let us know about any problems or malfunctions related to your flat's smoke alarms.
>