Any questions marked with an '*' must be answered to submit the form. Ability to self-evacuate survey Note: Questions marked by * are mandatory Privacy notice Silva Homes collects information about you when you complete forms relating to our services. We will keep your information safe and confidential as per our privacy notice. *This is a mandatory field. Please tick the box* I give consent to use my data *This is a mandatory field. Your full name* *This is a mandatory field. Your full address and postcode* *This is a mandatory field. Contact phone number* *This is a mandatory field. Are you able to hear the sounders in your flat?* Yes No If your answer is no, please provide details. *This is a mandatory field. If you are responsible for others within your home, would you be able to evacuate without assistance?* Yes No If your answer is no, please provide details.