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Me in poor condition (needs repairs) Want sheltered housing Need extra care (you will need to have a special assessment) Refugee (we will ask for proof of this) Health reasons (we will send you a medical assessment form to fill in) Other Please give details Under-occupation (your current property is too large for your needs) You have been evicted from (forced to leave) your home or your home has been repossessed 4 Personal information Please tell us why you ticked the relevant boxes on t.

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