Dear Sir/Madam,

The Centre’s staff is available to help you with any queries you may have or for any type of assistance you may require.
The law of 8 July 1976, which lays out the functioning of the Public Centre for Social Welfare (PCSW), that formal procedures are respected by the PCSW, and the fair treatment of all citizens.
Moreover, the Uccle PCSW fulfils its mission with the strictest respect for everyone’s ideological, philosophical or religious convictions.
The PCSW is required by law to carry out a preliminary social enquiry, during which you are obliged to provide any useful information on your situation. This questionnaire is intended to meet this legal obligation.
In order to carry out this purpose, the PCSW asks you to answer all the questions on this form as completely and sincerely as possible.
If you have difficulties reading or writing Dutch or French, please contact the reception unit of the PCSW, who will guide you to a social worker.

How to submit an application?

At the central administration (Chaussée d’Alsemberg, 860 – 1180 – Uccle)

1.  From Monday to Friday from 9.00 to 11.30 a.m.
2.  Ask for the form at the reception of the PCSW
3.  Answer the questions that apply to you
4.  Register at the reception desk to hand in the completed and signed form
5.  After submitting the duly completed form, you will receive an acknowledgement of receipt of your application and the necessary information for the social enquiry (e.g. name of your social worker, date of appointment, supporting documents to be prepared).

By electronic means

1. Download the objective data form (pdf): Download PDF
2. Answer the questions that apply to you
3. Scan and send the completed and signed form to: demande.sociale@cpasuccle.be
4. Once the completed form has been sent, you will receive an acknowledgement of receipt of your application and the necessary information for the social enquiry (e.g. name of your social worker, date of appointment, supporting documents to be prepared).

Note: Hospitals will make sure to attach a notice of admission and medical certificate (Emergency Medical Assistance [AMU] request if necessary) to the application.

If you do not have a printer, you can call us on the general number 02 370 75 11 and we will send them to you by post.

The social workers will be happy to help you fill in the form.

All personal data collected is processed in accordance with the Law of 30 July 2018 on the protection of privacy with regard to the processing of personal data and the European Regulation of 27 April 2016 on the protection of individuals with regard to the processing of personal data and on the free movement of such data in accordance with the Privacy and Confidentiality Policy of the PCSW of UCCLE, which is posted on the PCSW website or available on request. To find out more about the management of your personal data and to exercise your rights, you can contact our data protection officer at the following address: dpo@cpasuccle.be.