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Eligibility checker

Do you intend to move within the next 12 months?
Is the vehicle kept at your address?
Do you hold a blue badge?



Your details


Customer name


Customer address


Contact details

Your property details

Property type

Type of property
Are there any features outside your property that may affect you application
Features may include, but arent limited to:
  • Yellow lines
  • Limited waiting
  • bus shelters

Parking details


Do you have a garage available?
Is there space available for this on your property?


Do you have a driveway?
Is there space available for this on your property?

Nearby Parking

Do you have use of a nearby parking area?

Your disability

Is your disability permanent?
Can you walk unaided?
Questions All the time Often Sometimes Never
As a passenger, can you be left alone while the driver parks the car?

You benefits

Do you receive the mobility component of the Disability Living Allowance?
Which rate?
Do you receive attendance allowance?

Your Vehicle

Details of the Blue Badge holder's vehicle

Vehicle details

Is the vehicle entered from the rear?

Driver details

Are you the driver?
Drivers relationship to you
Do you hold a valid driving licence?

Your Blue Badge

Blue Badge details

Your application

Have you advised your neighbours of your application?
Did they have any comments?


This form should be signed by either:

  • the Blue Badge holder
  • the person completing this on behalf of the Blue Badge holder
  • the parking bay is only advisory
  • the parking bay cannot be formally enforced
  • other disabled drivers may use the parking bay