Disability Registration

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Privacy notice

The information you have provided will only be used to deal with your request and for statistical analysis. We will not disclose your information to third parties without your consent unless there is a legal requirement for us to do so.

New or lost card

Details of person completing form

Are you completeing this form on behalf of another person? *
Are you completeing this form on behalf of another person?
Title *
Title

Details of person requiring registration card

Title *
Title
Date of birth *
Date of birth

Reason for disability registration request

Sight

If you are having problems with your sight, see your GP or Optician. They can refer you to a Consultant Ophthalmologist (eye specialist), who will assess whether you qualify to register as sight impaired (partially sighted) or severely sight impaired (blind) and send on to us a Certificate of Visual Impairment (CVI).

Hearing

If you are having hearing problems, see your GP who can refer you to a hearing specialist.

 

Autism Spectrum Conditions

Including categories of Autism, Aspergers syndrome, High Functioning Autism and Pervasive Development Disorder.

 

Disability

You may select more than one box *
You may select more than one box

Other registration qualifying criteria

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