Helping monitor the vulnerable at home with COVID symptoms

IN PARTNERSHIP WITH

WHAT IS HOMS?

Hujjat are providing oxygen monitoring for free on a loan basis to those with COVID-19 symptoms and at risk. These devices allow you to monitor your oyxgen levels at home to manage the illness better.

WHO IS ELIGIBLE

• Adults with current COVID-19 symptoms and who have received a ‘vulnerable’ letter from the government
• Adults with current COVID-19 symptoms who are > 50 years of age
• Adults with current COVID-19 symptoms who have been invited to a ‘Hot Hub’ or a face-to-face review by their GP
• Others with current COVID-19 symptoms on a case-by-case basis

HOW WILL IT HELP?

Your GP/111/999 will use the oxygen saturation and heart rate readings from the monitor to help decide on the best treatment option for you. Without the monitor, you may not notice your oxygen levels dropping, but if we can detect this at an early stage, you could receive timely intervention to prevent your health getting worse.

Other factors they will consider include:

• Are you so breathless that you can’t speak in full sentences?
• Are you breathing harder or faster than usual?
• Are you so ill that you’ve stopped doing all your usual activities?
• Is your breathing faster, slower or the same as normal today?

HOW DO I ACCESS THE SERVICE?
Please complete this form to the best of your ability. If you are completing this form on behalf of someone else, please provide a contact number for yourself as well as your own email address.

We will endeavour to respond to your request within 24 hours, but in an emergency please dial 999. Hujjat will hold all data in confidence and only use it for the purpose of the Hujjat Oxygen Monitoring Scheme during COVID-19. The data will be destroyed after the COVID-19 pandemic in line with our Privacy Policy.

Please note: This form is specific to the Hujjat HOMS scheme. For other welfare issues, please visit hujjat.org/welfare

Full Name
Email
Phone
Date Of Birth:
Address Line 1:
Address Line 2:
City:
Post Code:
Next Of Kin Name & Number:
GP Name & Address:
Medical history: What medical condition(s) do you have?:
What Medication are you currently taking?:
What are your current Covid19 symptoms? :
How many days have you had symptoms for?:

Is anyone else in your household unwell?:–None–Yes No

Community:–None–Hujjat SLMCC SICM Harrow Central Mosque Harrow/local resident Other

Where did you hear about us:–None–Hujjat website Email Text / Whatsapp Word of mouth Other

Do you agree with our Privacy Policy? :

Do you agree with our Homs Disclaimer? :