HS-10 Home Safety Consent Form Owner/Occupier Details Name Telephone Client Address and Postcode I, the above, consent to: The fitting of safety items provided, where relevant, and in agreed positions. The fitting of safety items provided, where relevant, and in agreed positions. My personal data being held and used by Care & Repair Lanarkshire and other organisations if it is believed to be in my interest and is regarding home safety. My personal data being held and used by Care & Repair Lanarkshire and other organisations if it is believed to be in my interest and is regarding home safety. I acknowledge that I will: Assume ownership of all safety fixings, once fitted. Assume ownership of all safety fixings, once fitted. Be responsible for maintaining the equipment. Be responsible for maintaining the equipment. Be responsible for removing equipment when no longer required and for making good walls, frames etc., including decoration, plasterwork etc... Be responsible for removing equipment when no longer required and for making good walls, frames etc., including decoration, plasterwork etc... Owner/Occupier’s Signature: Date Witness’ Signature: Date SUBMIT FORM
