Damp & Mould Repair Form

Damp and Mould Repair Form

As well as calling or emailing us, you can raise non-urgent repairs online using the webform below.

Damp and Mould (#34)

Contact

First Name

Last Name

Phone/Mobile - please provide the best number for us to contact you on

Address

Address Line 1

Address Line 2

City

County

Postcode

Country

If we need to speak to you, when is the best time to call?

Early Morning - Before 10am

10am to Midday

Lunch 12pm - 2pm

Afternoon - 2pm - 5pm

Evening - After 5pm

Property Questions.

In this section we will require some information about the property.

What type of property do you live in?

Apartment/Flat

Bungalow

Detached

Maisonette

Semi-Detached

Terraced

Other

If other, please specify.

Areas affected by damp and mould.

This next section will help us understand the areas of your home that have damp and mould. We will ask you to provide the detail for each area one at a time.

Area (1) affected by damp and mould

If other, please specify

Within the reported area when is the damp and mould located?

100% of ceiling covered

75% of ceiling covered

50% of ceiling covered

25% of ceiling covered

100% of wall covered

75% of wall covered

50% of wall covered

25% of wall covered

100% of carpet/flooring covered

75% of carpet/flooring covered

50% of carpet/flooring covered

25% of carpet/flooring covered

Around window area

Around bath/shower

Around sink/basin

Around toilet

Around utilities

External walls

Is the damp and mould consistent throughout the year?

Yes

Which seasons does damp and mould occur?

Autumn

Spring

Summer

Winter

Has an operative attended the house for damp and mould previously?

Yes. But it has returned

Yes. But in a new area

Yes. But was unable to remove damp and mould

Is there damp and mould in another area of the property?

Yes

Area (2) affected by damp and mould

If other, please specify

Within the reported area when is the damp and mould located?

100% of ceiling covered

75% of ceiling covered

50% of ceiling covered

25% of ceiling covered

100% of wall covered

75% of wall covered

50% of wall covered

25% of wall covered

100% of carpet/flooring covered

75% of carpet/flooring covered

50% of carpet/flooring covered

25% of carpet/flooring covered

Around window area

Around bath/shower

Around sink/basin

Around toilet

Around utilities

External walls

Is the damp and mould consistent throughout the year?

Yes

Which seasons does damp and mould occur?

Autumn

Spring

Summer

Winter

Has an operative attended the house for damp and mould previously?

Yes. But it has returned

Yes. But in a new area

Yes. But was unable to remove damp and mould

Is there damp and mould in another area of the property?

Yes

Area (3) affected by damp and mould

If other, please specify

Within the reported area when is the damp and mould located?

100% of ceiling covered

75% of ceiling covered

50% of ceiling covered

25% of ceiling covered

100% of wall covered

75% of wall covered

50% of wall covered

25% of wall covered

100% of carpet/flooring covered

75% of carpet/flooring covered

50% of carpet/flooring covered

25% of carpet/flooring covered

Around window area

Around bath/shower

Around sink/basin

Around toilet

Around utilities

External walls

Is the damp and mould consistent throughout the year?

Yes

Which seasons does damp and mould occur?

Autumn

Spring

Summer

Winter

Has an operative attended the house for damp and mould previously?

Yes. But it has returned

Yes. But in a new area

Yes. But was unable to remove damp and mould

Is there damp and mould in another area of the property?

Yes

Area (4) affected by damp and mould

If other, please specify

Within the reported area when is the damp and mould located?

100% of ceiling covered

75% of ceiling covered

50% of ceiling covered

25% of ceiling covered

100% of wall covered

75% of wall covered

50% of wall covered

25% of wall covered

100% of carpet/flooring covered

75% of carpet/flooring covered

50% of carpet/flooring covered

25% of carpet/flooring covered

Around window area

Around bath/shower

Around sink/basin

Around toilet

Around utilities

External walls

Is the damp and mould consistent throughout the year?

Yes

Which seasons does damp and mould occur?

Autumn

Spring

Summer

Winter

Has an operative attended the house for damp and mould previously?

Yes. But it has returned

Yes. But in a new area

Yes. But was unable to remove damp and mould

Is there damp and mould in another area of the property?

Yes

Area (5) affected by damp and mould

If other, please specify

Within the reported area when is the damp and mould located?

100% of ceiling covered

75% of ceiling covered

50% of ceiling covered

25% of ceiling covered

100% of wall covered

75% of wall covered

50% of wall covered

25% of wall covered

100% of carpet/flooring covered

75% of carpet/flooring covered

50% of carpet/flooring covered

25% of carpet/flooring covered

Around window area

Around bath/shower

Around sink/basin

Around toilet

Around utilities

External walls

Is the damp and mould consistent throughout the year?

Yes

Which seasons does damp and mould occur?

Autumn

Spring

Summer

Winter

Has an operative attended the house for damp and mould previously?

Yes. But it has returned

Yes. But in a new area

Yes. But was unable to remove damp and mould

Is there damp and mould in another area of the property?

Yes

Area (6) affected by damp and mould

If other, please specify

Within the reported area when is the damp and mould located?

100% of ceiling covered

75% of ceiling covered

50% of ceiling covered

25% of ceiling covered

100% of wall covered

75% of wall covered

50% of wall covered

25% of wall covered

100% of carpet/flooring covered

75% of carpet/flooring covered

50% of carpet/flooring covered

25% of carpet/flooring covered

Around window area

Around bath/shower

Around sink/basin

Around toilet

Around utilities

External walls

Is the damp and mould consistent throughout the year?

Yes

Which seasons does damp and mould occur?

Autumn

Spring

Summer

Winter

Has an operative attended the house for damp and mould previously?

Yes. But it has returned

Yes. But in a new area

Yes. But was unable to remove damp and mould

Photographs

Please upload photographs of the damp and mould. It is really important we receive the images so that Vivo/Amey can have a better understanding of the situation and create a plan of action to rectify this issue. If you are having difficulty doing this, we can arrange for a Housing Officer to attend and take the photos for you and send them in to us.

Image Upload (jpg and png format)

Choose File

Please add any additional information that is helpful to us below.

Thank You.

Thank you for completing the form. We will raise a job with DIO's maintenance contractors Amey / Vivo who will contact you directly to discuss the next steps.

If you have any additional questions you can call us on 0800 031 8628, selecting option 1, then option 4. Or you can send us an email to [email protected].