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Fuel Poverty Agency Referral Form

Please complete the form on this page if you are an Agency partner referring a client to CHA's Lemon Aid Service.

Referring Agency Details

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Customers Details

This area must be competed at all times for the referral to be accepted by Lemon Aid
PLEASE NOTE BELOW ISSUES / ASSISTANCE REQUIRED FROM LEMONAID. LEMON AID CANNOT ASSIST WITH NEW TENANCY MOVE-INS. LEMON AID NO LONGER OFFER AN ENERGY SWITCHING SERVICE. IF THE REFERRAL RELATES TO ANY OF THESE AREAS WE WILL NOT BE ABLE TO CORRESPOND WITH THE REFERRED CUSTOMER.
By typing your name in this box you are giving permission for the provision of information relating to my advice needs to the Citrus Energy Team. I understand and agree that all information given will be available to both of these parties at all times for the purpose of assisting me in my Energy bills.
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