Mobility Travel Pass - Medical Information Form

What is this for?

Form to provide medical information about your restricted mobility in support of a Mobility Travel Pass Application.

What is it going to cost?

Free.

What we need from you

We will ask you to register for a MyDoncaster account if you haven’t already. This will allow you to track your enquiry, and for us to tell you the outcome of your request. You will also be able to access additional online services offered by us.

We will ask you to tell us details of your restricted mobility. A Doctor or medical professional will have to complete and sign part of the form. We are unable to assist with any costs in providing this information.

You should download and complete part 1 and 2 of the form below and your Doctor or medical professional should complete part 3:

Mobility Travel Pass medical information request form

Once complete please return to this page and upload the form using the DO IT NOW button below.

What you should expect from us

Once submitted, we will use the information to determine your claim for a Mobility Travel Pass. We may need to contact you if further information is required to process your request.

More information

Do it Now
Last updated: 07 December 2017 15:16:32