I am happy to give the personal details required for processing this form. I understand that they will be stored for 7 years.
I understand that they will be used to make a community trigger report and may be shared with the Police, Fire Service and a registered housing provider (social landlord).
I understand that I can withdraw or update my details at any time. For more information about how we store your data and how you can request your right to withdraw consent to use your personal data later please read How we use your data.