Health and Social Care enquiry form

Fill in this form for help and advice about adult social care. We will usually reply by the next working day, to give you an answer or to find out more about your situation.

Do not use the form in an emergency or if your enquiry is urgent. During office hours, you should telephone 0161 909 6517, text 07970 134894 or minicom 0161 909 6527. At other times contact the emergency service on 0161 794 8888.

If you are worried that someone is in immediate danger of being abused call 999. Further information is available about safeguarding vulnerable adults.

If your enquiry is about welfare rights (benefits) or about debt advice, you can contact our welfare rights and debt advice service.

If your enquiry is about a child, you should contact our Referral and Initial Assessment Team.

About your enquiry

I am enquiring about:
myself
someone else

If you are enquiring about someone else, do they know you are making this enquiry?
yes
no

Your details

Please give as much information as you can. You must give us at least one method of contacting you.

Title (Mr, Mrs, Ms, Dr, etc)

First name

Last name

House number and street name

Area

Town

Postcode

Your country (if not United Kingdom)

Telephone number
(Please include area code)

Mobile number

Email address

Details of the person you are enquiring about

If you are enquiring about someone else, please give us as many of their details as you can.

Title (Mr, Mrs, Ms, Dr, etc)

First name

Last name

Date of birth

House number and street name

Area

Town

Postcode

Telephone number
(Please include area code)

Email address

Contacting you

How would you prefer us to contact you?
Telephone
Email
Mobile
Letter

What is the best time to contact you (UK time)?
morning (8.30am to 12.30pm)
afternoon (12.30pm to 4.30pm)

Information or advice

I want information or advice about
(Hold down Control key to select more than one item)

More information

If your enquiry isn't listed above, or you want to give us more details, please use the space below.

This page was last updated on 22 November 2011

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Salford City Council, Salford Civic Centre, Chorley Road, Swinton, Salford M27 5AW

0161 794 4711

Improving people's lives IN Salford