***VAT Exemption form***

If you are in any doubt as whether you are eligible to receive goods or services zero rated for VAT you should consult HMRC notice 701/7 VAT release for disabled people, or contact the national advice service on 0845 010 9000 before signing.  Please complete all areas in full - Failure to do so will mean that your order will NOT be dispatched.

By filling the details below you declare that you are chronically sick or disabled by reason of (Medical Condition):

(Typing your details below makes this a legal document)

I have read and understood that I am eligible for VAT exemption
and understand the consequences of failure to give us the correct information:  


I Declare that I am chronically sick or disabled by reason of (Medical Condition): 

The goods that are being supplied to me are for my domestic and personal use and I claim relief from the VAT.  By clicking the box tells us that you have read and understood the consequences of failure to give us the correct information: