Free Home Fire Safety Check Survey

Last updated: 21/01/2013 Add to My Bookmarks Subscribe

To help us determine if you are eligible for a free home fire safety check, please complete the short survey below. If you are eligible, an officer will contact you and arrange a convenient time to visit your home. Please be aware that there is a waiting list in place.


DATA PROTECTION: The information you provide on this form will be held by Cornwall Fire and Rescue Service. Your information will not be used for any other purpose by Cornwall Council, and will not be passed onto any other third party without your permission. In accordance with Cornwall Council's Record Retention Policy, the information you provide on this form will be retained for its purpose, after which period it will be destroyed in a secure manner. All personal information held by Cornwall Council is held safely in a secure environment.

Mandatory questions are marked with a *
Are you the occupier of the property?*
If no, please tell us your name and your relation to the person you are contacting on behalf of, your name:
Your relationship:

First name of occupier of the property*
Surname of the occupier of the property*
Address of the property to be visted (including full postcode)
Flat/house name or number*
Street/road name*
Town*
Postcode*
Daytime contact number*
Email address
What is the age of the oldest person living in the property?*
Does anyone in the property smoke?*
Does anyone in the property have a disability or long-term limiting illness?*
Does the occupier of the property live alone?*
Is the occupier of the property a lone parent (of a child aged 16 or under)?*
Please add any additional information here:

Cornwall Fire & Rescue Service banner - Working together to make Cornwall safer

Fire Safety in the home

Keeping Safe

Cornwall Fire and Rescue Service Homepage