Application for Assessment

Please read the leaflet below to learn about the process and criteria for our aids and adaptations service before applying. Thank you.


Email address (required)

Address (required)

Telephone number (landline)

Mobile number

Name of preferred contact (if different to above)

Contact telephone number

Contact email address

Which areas in your home do you feel require adaptations (please tick all that apply)


Please explain why you feel these areas require adaptations, including the issues that you're experiencing. Please provide as much detail as possible:

Eastlight will process the information you have provided to assess your request for adaptation. This information will be passed on to an independent occupational therapist who will make recommendations based on your needs. If the recommendations don’t fall within our remit your application will be passed to Braintree District Council to be considered for a Disabled Facilities Grant.

For further information regarding how we may use, store, process and share your personal information please see Our Privacy Policy.