[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-306061-105":53,"doc-detail-306061-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","medical-application-form-housing-association","Medical Application Form - Housing Association","","Medical Application Form for Wellhouse Housing Association for applicants seeking rehousing support based on health and disability needs. Collects details for main and joint applicants, including formal identification requirements, personal data, contact information, current landlord, and comprehensive health issues such as mobility needs, adaptations, stairs access, garden requirements, and potential future deterioration. Includes sections for support arrangements, support services, required declarations, and data protection consent describing confidential handling and information sharing to assess rehousing eligibility.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/medical-application-form-housing-association/306061/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/medical-application-form-housing-association/306061.png","ImageObject",442,249,{"name":88,"@type":89},"Felix Montgomery","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-09","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":9},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What documents are required when submitting this medical application?","Question",{"text":108,"@type":109},"Formal photographic ID and proof of a National Insurance number are required for all applicants, and proof of address for everyone being rehoused must also be submitted.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What health-related questions does the form ask?",{"text":113,"@type":109},"It asks whether an illness or disability applies, the nature of the disability, how current housing worsens the condition, and mobility and housing accessibility needs such as wheelchairs, stairs, adaptations, and future deterioration.",{"name":115,"@type":106,"acceptedAnswer":116},"How is the information provided in the form handled?",{"text":117,"@type":109},"Information is treated in confidence and complies with relevant data protection legislation. It may be verified by relevant parties and shared with other third parties to assess the application, for the purpose of evaluating current and previous housing circumstances and rehousing needs.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},306061,1791562463,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":135,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":79,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":73},549768064778,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Wellhouse Housing Association  \n49 Wellhouse Crescent Glasgow G33 4LA  \nMedical Application Form  [info@wellhouseha.org.uk](info@wellhouseha.org.uk)  \n[www.wellhouseha.org.uk](www.wellhouseha.org.uk)[ ](www.wellhouseha.org.uk)0141 781 1884  \nRegistered Scottish Charity No: SCSC036552  \nMAIN APPLICANT  \nFormal ID (photographic is preferred) and proof of National Insurance Number is required for all applicants Proof of address for all people to be rehoused is also required, please submit this ID along with this form.  \n\n| Title |  |  |  |\n| --- | --- | --- | --- |\n| First Name |  | Surname |  |\n| Date of Birth |  | NI No. |  |\n| Address |  | Postcode |  |\n| Contact Number |  | Email |  |\n| Current Landlord |  |  |  |\n\nJOINT APPLICANT  \nPlease complete this section if someone is applying with you as a joint applicant  \n\n| Title |  |  |  |\n| --- | --- | --- | --- |\n| First Name |  | Surname |  |\n| Date of Birth |  | NI No. |  |\n| Address |  | Postcode |  |\n| Contact Number |  | Email |  |\n| Current Landlord |  |  |  |\n\nHEALTH ISSUES  \nDo you, or anyone to be rehoused with you, have an illness or disability? If yes, please provide more information  \n\n| Name of person |  |\n| --- | --- |\n| What is the nature of your medical disability? |  |\n| Please give details how your current housing situation is worsening the illness or disability |  |\n\nDo you or anyone to be rehoused with you require to use a wheelchair, walking stick or walking frame? If yes, provide more information  \nHas your current home been specially adapted or built specifically for your health condition? If yes, provide more information  \nIs it likely that anyone to be rehoused will require a wheelchair in the foreseeable future? If yes, please provide more information  \nDoes your current house have internal or external stairs?  \nIf yes, how many?  \nHow many stairs can you manage?  \nDo you have a garden? YES/NO  \nIf so, is a private garden space essential because of the medical condition of anyone to be rehoused with you?  \nIs a separate bedroom required for the person with a medical condition or for a carer? Please give details:  \nIs the person with the medical condition able to manage a bath? YES/NO  \nDoes the person with the medical condition require a separate shower unit instead of a bath? YES/NO  \nIs the medical condition likely to deteriorate in the future?  \nIf so, please give details:  \nDo you receive any allowances or benefits due to your health condition or disability? YES/NO  \nIf your health problem is not covered by any of the above questions, please tell us how your housing affects your illness or disability, and how you feel being rehoused would help  \nSUPPORT  \nDo you need to move house to be near a relative or friend, to receive care and support? If yes, please provide details of that person:  \n\n| Name of person who provides support  |  |  |\n| --- | --- | --- |\n| Address |  |  |\n| What type of support is provided and how often? |  |  |\n\nSUPPORT SERVICES  \nDoes anyone to be rehoused with you receive support from a support agency? Please provide details:  \n\n| Name of support provider |  |  |\n| --- | --- | --- |\n| Contact details |  |  |\n| What type of support is provided and how often? |  |  |\n\nDECLARATION  \nI/We certify that the information given is a true record of my / our present circumstances, if not the application may be invalidated OR withdrawn OR cancelled. The Association has the right to apply in court for repossession of any dwelling / accommodation, where the tenancy was found to have been granted on the basis of false or misleading information.  \nI / We agree to inform Wellhouse Housing Association of any change in my / our circumstances. I/We authorise the Association to make any necessary enquiries or investigations to confirm the details of this application.  \nDATA PROTECTION  \nAll the information provided within this application will be treated in confidence and comply with the relevant data protection legislation. The information within ","cbCaifjrMU53ZNyL","https://ap.wps.com/l/cbCaifjrMU53ZNyL","pdf",452867,7,"English","# Main Applicant\n# Joint Applicant\n# Health Issues\n# Support\n# Support Services\n# Declaration\n# Data Protection","[{\"question\":\"What documents are required when submitting this medical application?\",\"answer\":\"Formal photographic ID and proof of a National Insurance number are required for all applicants, and proof of address for everyone being rehoused must also be submitted.\"},{\"question\":\"What health-related questions does the form ask?\",\"answer\":\"It asks whether an illness or disability applies, the nature of the disability, how current housing worsens the condition, and mobility and housing accessibility needs such as wheelchairs, stairs, adaptations, and future deterioration.\"},{\"question\":\"How is the information provided in the form handled?\",\"answer\":\"Information is treated in confidence and complies with relevant data protection legislation. It may be verified by relevant parties and shared with other third parties to assess the application, for the purpose of evaluating current and previous housing circumstances and rehousing needs.\"}]","Medical Application Form - Housing Association | PDF",1789832590]