Delfont Mackintosh Access Registration

Disabled person's name

Your name (if different)

Address

Telephone number

Consent

In order for us to process your access registration, we need to process information related to your medical condition. This is deemed by the Data Protection Act to be sensitive information. We will not do this without your explicit consent. For more information on our Privacy Policy and how we process information please see the website. If you do not give consent we will not process your application and all information will be permanently deleted upon receipt.

I consent for Nimbus to process sensitive information about me in order to make a decision on my entitlement to a card

About your Disability / Impairment / Health Condition Mobility Impairment Visual Impairment Hearing Impairment Learning/Cognitive/Neurodiverse Impairment Behavioural Impairment Mental Health Impairment Speech/Language Impairment Continence Impairment Other Impairment

Standing and queuing

Wheelchair access

Access to toilets

Assistance dogs

Long distances

Personal assistants / additional support

Accessing visual information

Accessing audible information

Anything else

Back Next

Upload a scan/clear photo of your benefits entitlement or a Dr's letter

This is to upload any evidence you have to support your application.

Please see below for examples of what we can, and cannot, take into account for your application:

Confirmation of Disability Living Allowance, Personal Independence Payment, or Attendance Allowance
- This must be recent and clearly show the Name and Address of the recipient
- This must clearly show the rates of Mobility and Personal Care / Daily Living components you have been awarded
- We cannot take into account Covid Extension letters, ESA, UC, Blue Badges, Appointment Letters or Christmas Bonus letters
A letter from a 3rd party professional aware of your needs
- This must be recent and clearly state the diagnosis and impact of your conditions described in your application.
- This must be on surgery / official headed paper.
- Confirmation of diagnosis alone for conditions with variable
We may be able to take a variety of other documents into account such as occupational health reports, care plans, EHCP’s, OT assessments.
- If you would like to discuss what other information we can take into account on your application please let us know

If you do not have any of the above to hand and would like to receive a form from us for completion please submit an application through using the link below and request the forms in the "About Impairment" section.

The forms we have for completion are only used as a last resort for those who do not have any other relevant supporting documentation, as it is very common that medical professionals will charge you to have these completed.

Upload a scan/photo of your government-issued photo ID

Upload a photo of your face

Upload anything else you think might be useful

Upload a link to any media about you that you think may help us make a decision

Back