Priority Services Register - Application form

The Priority Services Register is free to join. It helps us to look after customers who have specific communication, access or safety needs. If you live in London, the South East or the East of England, we can offer extra support when you need it, for example if you experience a power cut. To be added to our Priority Services Register, please complete our short form below.

If you would like to receive a copy of our Priority Services Register application form in large font, in EasyRead, or in Braille, please call 0800 169 9970 or email us at psr@ukpowernetworks.co.uk and we’ll be happy to arrange this for you. You can also download our EasyRead form and language forms from our Priority Services resources and downloads web page.

For more information on how we will treat your personal data, please read our Privacy Policy and our Priority Services Promise.

Mandatory questions

Questions which have a star (*) after them are mandatory fields. You will not be able to complete the form without answering these.

Address

Address *

Who should we contact about the property during a power cut?

Title *

First name *

Last name *

Preferred contact number *

Alternative contact number

Email address

Is there anyone else you would like us to contact during a power cut?

Title

First name

Last name

Preferred contact number

Alternative contact number

Email address

Home visit security password

Looking after your information

To offer this service, we'll keep the information you have given us and only contact you to provide you with support during a power cut or to provide information about the Priority Services Register or other essential services. Your personal information will not be used by us or our partners for marketing purposes, but we work with a range of support partners or other organisations that may contact you for feedback about our service. You can update your information at any time. If you are completing this form on behalf of someone else, by completing it you confirm that you have the permission of that person to do so.

Would you like to receive priority support from your energy supplier (the company you pay your energy bills to) including their meter operators and your gas distribution company? We may also be able to share your information with your water supplier to enable you to receive their priority support, depending on who your supplier is. Please tick this box if you are happy for us to pass your information to your energy and water supplier (if your water company is part of our priority services collaboration).

Yes

Priority Services Register - Application form

Address

Who should we contact about the property during a power cut?

Is there anyone else you would like us to contact during a power cut?

Please let us know your reason for registering by selecting any of the options applicable to you or anyone else living in the property*

How did you hear about us?

Looking after your information