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VAT Exemption
I declare that I am (or acting on behalf of) a person with a physical or mental impairment which has a long-term and substantial adverse effect upon my ability to carry out everyday activities:
I declare that I am a person who is chronically ill with a long-term condition (such as diabetes) or terminally ill:
I am acting on behalf of a charity, healthcare body, hospital or hospice with charitable funds (Under separate rules: for more information see VAT Notice 701/6 Charity funded equipment for medical, veterinary etc.):
I declare that I am NOT frail elderly person who is otherwise able-bodied, or any person who is only temporarily disabled or incapacitated, such as with a broken limb - because VAT is charged:
Please state your long-term medical condition (Arthritis, COPD, etc.) or organisation (with charity number): *
 
If you have any problems, please call us. Please be assured that all information is kept between ourselves and the HMRC.
Full Name: *
Address: *
Postcode: *
*
Please add the two numbers and enter the result, this is to prove you're human and not a spam robot.