South West Water - Priority services registration form

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Priority services registration form

The information you provide is kept on a secure register restricted to only those employees of South West Water and our partners who need to know it. It is not disclosed to anyone else under any circumstances.

	To complete this form you will need
1.	Your customer reference number which can be found on your bill.
2.	An email address and telephone number that we can contact you or your representative on.

Please complete all the information fields marked *

Your Details

Customer Reference Number

Title

Forename

Surname

Telephone number (including area code)

( ) *

Your Address

House/premises name

House number & street name

Town/City

County

Postcode

Services to assist you with your account

I wish to receive my bills in large print

I wish to receive my bills in braille.

I would like you to ring me each time my bill is produced with information of the amount due.

I would like you to send my bill to an agreed friend or relative on the understanding I pay for the bill.

	Name of friend/relative
	Title
	Forename
	Surname
	Friend/Relative Address
	House name
	House number & street name
	Town/City
	County
	Postcode
	Telephone number (including area code)	( )

I would like to receive a copy of the bill as well.

I would like to be able to ring to request a meter reading up to once a month.

Services to assist you during work on our network

I would like to receive a warning from you by;

		telephone writing visit

I have a medical condition which means that my health would be put at risk during a prolonged interruption. Please make special arrangements to provide me with water.

Information request

I would like the following information

		Meter Option Booklet Meter Questions and Answers Water Wise Top Tips WaterSure Information Complaints Procedure Charges Scheme Our Customer Promise

Please supply the information in the following format.

		Audio cassette Audio CD Daisy CD Paper Version