Medical assessments

We may be able to award additional priority if you, or someone that is moving with you, has a medical condition.

• that is affected by your current home or
• where a move to a more suitable property would improve the condition or make it easier to manage; 

For us to assess whether we can award you a medical priority, you will need to complete a medical form.

In addition to completing a medical form, you must provide supporting information from a:

• consultant
• occupational therapist
• consultant psychiatrist
• or equivalent

They will need to confirm your medical conditions, how your medical conditions are affected by your current home and how a move to a different home would improve your conditions or make them easier to manage. This information can be attached to the web form below.

If you have a medical conditions but a move will not improve it or make it easier to manage then we will not award any medical priority.

Once your medical application and all the supporting evidence is received it may either be referred to the council’s medical referee for assessment, or it will be assessed at the next monthly medical panel. Once it's been submitted to the medical referee it will take about 10 working days for a decision. We will tell you what that decision is and if a recommendation has been made for additional priority to be awarded.

Please fill in the medical form:

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To help us reply to you promptly, please answer all questions as fully as possible.

*Required information.

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What are your medical conditions or disabilities? *

What medication are you taking? *

Evidence of your medical condition and medication (you can upload scanned or photographed copies of evidence but please make sure it is clear and readable)

What type of property do you live in? *

How many bedrooms do you have? *

Does your property have any disabled adaptations? If it does please give details of the type of adaptation/s. *

If you live in a flat, which floor do you live on?

If you live in a flat, is there a lift? Please select Do not live in a flat Yes No

How does your current home affect your illness and how would a move help? *

Doctor's name *

Doctor's address *

Doctor's phone number *

Your application/bidding ref *

Your name *

Your date of birth *

Your gender * Please select Male Female Other

Your address *

Your postcode *

Your phone number

Your email address *

Your Declaration Under Section 160a of the Homeless Act 2002 the council may refuse rehousing to those applicants and family members who have a history of serious anti-social behaviour. The council have a policy to work with the Community to reduce anti-social behaviour and to improve the prevention and detection of crime.

I/we confirm that the information given on this form is correct and that if I/we have given false or misleading information the council or its managing agents are entitled to take legal action if any person obtains, or attempts to obtain, accommodation as a result of giving false or misleading information. *

I/we understand I must notify the council of all changes affecting my/our application as soon as they occur. This includes any changes to contact details and changes in my/our housing circumstances. *

I/we authorise you to undertake appropriate checks to verify the information I/we have provided at all stages in my/our application for housing, including sharing information with the Housing Benefits department, any other council department, any other council, registered social landlord, private landlord or managing agents, Department of Work and Pensions, West Midlands Police, National Fraud Initiative, NHS, employers, or any other agencies. Any personal information will be processed in accordance with the requirements of the General Data Protection Regulations or any subsequent data protection legislation. For more information on how we use and share your information please refer to our Privacy Notice which is on the Wolverhampton Homes website. However, if you would like a written copy of this please contact any Wolverhampton Homes Office. *

I/We understand that any landlord may take legal action, under the Housing Act 1985, if any person obtains accommodation as a result of giving false or misleading information. This authority is under a duty to protect the public funds it administers, and to this end may use the information you have provided on this form for the prevention and detection of fraud. It may also share this information with other bodies responsible for auditing and administering public funds for these purposes. *

For further information please visit the council's webpage on fraud. Click here for more information.

The Council is under a duty to protect public funds and may use the information held or provided by you for the prevention and detection of fraud. For more information on how we use your data to do this please visit our privacy page.