Application for Equipment – Referral for an Individual

Requests for individuals should be made by third-party referral (not a relative). Examples of third-party referees include charities, government departments or initiatives, community groups, community or social workers, schools, churches or church groups or local councillors.

Please read the Equipment Receipt and Disclaimer that recipients must sign on receipt of equipment. (Updated 27/7/21)

  • All information provided will be treated in confidence in accordance with our GDPR Policy.
  • We may ask for evidence of eligibility.
  • The final decision on applications lies with the PCrefurb Trustees.

This form is to apply for equipment for residents of Tameside and the High Peak of Derbyshire.

Please read information on the geographical areas we cover.

View our current service status for stock levels and the waiting list.
If the need is urgent, please let us know on the form or contact us.

Step 1 of 4

Application for Equipment

PLEASE CONSIDER: If your client is able to access publicly available computers at libraries and Job Centres, for example, then please consider that as an alternative to requesting equipment from us.
If your client has any additional needs or difficult circumstances which mean that a device at home is the only appropriate option then we are very happy to try and help. We ask you to differentiate due to the significant demand on our services.

Referrer Details

Return to Application information page

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