Adviceline Questionnaire

This form provides us with an outline of your concern, so that we are prepared when we contact you.

Step 1 of 4

This form is split into 4 steps.

Step 1 is about your privacy and checks if this is the right service for you.
Step 2 is used if someone else is completing this form on your behalf.
Step 3 is about you and the help you need.
Step 4 is for Equalities and Monitoring Information.

The form is not long, but if you cannot complete it in one go, click on the ‘save and continue later’ button to save your answers. You can then go back and complete it at a later time.

Step 1

This step is about your privacy and checks if it’s the right service for you

Privacy

Our online form below allows you to request a call back or email from one of our Advisers.

Before you share your information with us, it’s important you know what happens with this information and that you agree with it. Please read the information below, and see our privacy policy for more details.

If you would like us to email you advice it’s important that you are confident no one else can access your email account. We suggest you don’t use a work account because other people may have access to this information.

It’s important to remember that emails may not be encrypted and can be intercepted so do not ask us to email you advice if you want to maintain strict online security and confidentiality – a telephone call is more secure than email.

We will store any information provided in the form for as long as is needed to deal appropriately with your enquiry, for the purpose of providing you with an advice service.

By sending this form you are consenting to share your information with Moneyworks’ Partnership organisations (Money Advice Plus/ Citizens Advice Brighton and Hove/ Possability People and St. Lukes Advice Service) for the purpose of providing advice on your enquiry.

Consent(Required)

I have read the privacy information above and am happy to proceed.

Yes

Your location

Do you live in Brighton & Hove?(Required)

Yes

You've told us that you don't live in Brighton & Hove. Have you been placed in Emergency Accommodation outside the Brighton & Hove area by Brighton & Hove Council?(Required)

Yes

This service can only assist people who live within the Brighton and Hove Area or have been placed in emergency accommodation by Brighton and Hove City Council outside the Brighton and Hove area.

If you are a victim-survivor of domestic abuse and live outside Brighton and Hove, you could contact the Financial Support Line on freephone 08081 968845

It is a nationwide telephone advice line and can only be accessed by calling the number. For further information, please go to: Financial Support Line

Please do not complete this form, it does not provide access to the Financial Support Line.

Adviceline Questionnaire

Step 1

Privacy

Your location

Step 2

Step 3

Phone messages

Please tick all that are appropriate:

Please tick all that apply:

Please tick all that apply:

Please tick all that apply:

Work & Benefits

Please tick all that apply

Debt Advice

Please tick any that apply.

Please tick any that apply.

Immigation

Step 4

Equalities Monitoring Information