Please note that fields marked * are required
You can use this form to submit a request for help to the municipality. We call this a Wmo notification. Wmo is the abbreviation for Wet maatschappelijke ondersteuning (Social Support Act).
Do you have any questions about using this form? Please contact the team Uitvoering Sociaal Domein via the general telephone number (0475) 85 90 00. The Social Domain Implementation team can be reached on Monday, Tuesday, Thursday and Friday between 09:00 and 12:30.
This form makes mandatory use of DigiD or eRecognition.
Are you submitting this form for yourself? Then you are using DigiD. Please have your DigiD log-in code ready. Do you not yet have a DigiD? Please visit www.digid.nl for more information and applications.
Do you support a client and submit the application on behalf of a client? Then you need to use eRecognition. For more information and applications go to eHerkenning.nl
