Apply for a discount for someone with a severe mental impairment

Before completing this form please make sure you have:

• the applicant's council tax number
• the completed Severely Mentally Impaired certificate from a medical practitioner and
• the benefit entitlement letter (please make sure any attachments are sized at less than 10MB)

If you need help to complete this form get support

About this form:

You have about 20 minutes to fill in each page of this form.

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