Priority Services Request

Title*

First Name*

Surname*

Customer Reference Numberi * this is the 10 digit number that appears on your water bill If you don’t have it right now, don’t worry, you can still register with us.

Preferred Contact Number* Please provide your preferred phone number so we can get in contact with you in the case of a water incident

Email*

Property Number/Name*

Road or Street name*

Town / City*

Postcode*

2. About your needs

To ensure we can provide you with the best support, please tell us which of the below applies to you or someone living in your home

Select all that apply...

Please indicate if it is Renal or CAPD dialysis

3. About how we can help you

Nominee Scheme

If you have difficulty communicating or find it hard to understand your bill and other information we may send you, you can nominate a carer, family member of friend to speak to us on your behalf.

Would you prefer us to contact a carer, family member or friend on your behalf.

About your nominee

Nominee title*

Nominee First Name*

Nominee Surname*

Nominee Property Name / Number

Nominee Street

Nominee Town / City

Nominee Postcode

Nominee preferred phone number*

Nominee email address

Would you like to receive your water bill or any other requested leaflets in a different format?

Please let us know how you would like to receive them?

Would you like this translated into another language?

What language would you like it to be translated to?

Help during water supply interruptions

Occasionally, we may need to turn the water supply off to carry out essential works. We have a variety of means to let you know in advance but if you have additional needs, we can tailor our communications to suit your requirements. If the water is off for a longer period and you would have difficulty in collecting bottled water, we can arrange to get this delivered to you.

Would you like to be contacted and receive additional support if the water supply goes off?

Reading Your Water Meter

If you have a water meter fitted and have difficulty reading it, we can arrange for one of our staff to read your meter more frequently.

If you have additional needs and wish to read your own meter, we can re-locate the meter, or discuss alternative options to make it easier for you to read.

Would you like help reading your meter?

Sharing Information

Are you happy for Wessex Water and Bristol Water to use your personal and health information to provide you with additional services if there is an incident which affects your water supply?

Is it okay for us to share your personal details and reason for registering with your energy/utility suppliers or networks so they can register you for their priority services?

Sharing your contacts information

Can you confirm that your contact is happy for us to use his/her details and share them with your energy/utility suppliers or networks so he/she can be contacted about priority services for you?

Sign up for Priority Services

Our Priority Services register is for customers who need a little extra help and support. We have a range of free services available which can be tailored to your individual needs. To register for one or more of our additional support services, simply fill in the form below.

Bristol Water Bar!

You could save money with a water meter!

Activities at the lakes

You could save money with a water meter!

Activities at the lakes

Sign up for Priority Services

Our Priority Services register is for customers who need a little extra help and support. We have a range of free services available which can be tailored to your individual needs. To register for one or more of our additional support services, simply fill in the form below.