Register as disabled form

  • Address
  • Contact details
  • How would you prefer us to contact you?
  • You don't have to tell us your ethnicity. We only ask to make sure we're meeting the needs of all our customers.

  • Have you seen an occupational therapist or a social worker?


When you submit this form you are sending your information to Hertfordshire County Council to register as disabled. We'll only contact your doctor for them to share relevant information with us if you give your consent on this form.

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