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Application Form to Request a Medical Exemption
Application Form to Request a Medical Exemption
The information which you provide on this form will be processed by Glasgow City Council (which is the “data controller” for purposes of the data protection law). A Privacy Statement explaining how we process your personal information can be found
here
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Application Form to Request a Medical Exemption. This is an application to request to be medically exempt from mobility assistance duties imposed on drivers under the Equality Act 2010.
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Section 1. Personal Details
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First Name(s)
*
Surname
*
Date of Birth
*
Address 1
*
Address 2
Address 3
Town/City
*
Postcode
*
Phone Number
*
Email
*
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