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Personal Emergency Evacuation Plan (PEEP)


Self-referral form

You’ve arrived at this form because we recently contacted you about fire and building safety at your property. We want to make sure everyone can leave their building safely in an emergency.

A Personal Emergency Evacuation Plan (PEEP) is a short, confidential plan that sets out any support you might need to evacuate safely. Completing this form helps us understand whether a PEEP would be helpful for you.

This is not a tenancy review, and it will not affect your home. Your information will be kept confidential and only shared with colleagues or emergency services who need it to keep you safe.

Please answer the questions below so we can assess your needs and, if required, create a personalised evacuation plan.





About you
(including flat number and postcode)



Your household





(Tick all that apply)







e.g. ground floor, 1st floor, 2nd floor etc.




Consent
Recite Me