Positive energy – request forms

Positive energy - request services

Use the forms on this page to make a Home and Well referral. request Priority Registration for your household, or request FREE Carbon Monoxide alarms. You use these same forms to make requests for yourself and/or on behalf of a neighbour or family member that you are caring for. We are no longer able to provide Carbon Monoxide monitors/alarms, and referrals to the Home and Well scheme must be made via the Citizens Advice Hampshire website.

Priority Service Register (PSR)

Priority Service Registration

You may be eligible for Priority Service Registration if:

  • you are of pensionable age
  • you are pregnant or living with children under 5 years old
  • you have a hearing or sight condition
  • you are recovering from an injury or have recently come out of hospital
  • you have a long-term medical or mental health condition
  • you are disabled
  • you have extra communication needs (e.g. English is not your first language)
  • you have experienced a recent bereavement, break-up, or job loss

You may use this same form to register neighbours or family members. Please get their consent before providing their data.

You only need register once, here, to be covered for Electricity, Gas and Water outages.

The data you provide be held by Good Neighbours Network, SGN and their partners, solely for the purposes of processing your registration.

Home and Well referrals

Here’s where you can refer yourself or a client, neighbour or family member to Citizens Advice for the Home and Well service.

A friendly local adviser will then make contact.

They offer advice and support that is not means tested so no matter what is on your mind they will ensure you are able to access what is available to you.

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