VAT relief declaration

If you are chronically sick or disabled, you may be able to buy eligible products from us without VAT. Fill in this form and send it to us before or with your order.

Who can claim

You can claim if you have a physical or mental impairment with a long-term and substantial effect on your ability to carry out everyday activities, or a condition the medical profession treats as a chronic sickness.

You cannot claim if you are only temporarily injured or unwell (for example a sprain or broken bone), if you are older but not chronically sick or disabled, or if the products are for business use or for use in a hospital or nursing home.

We cannot tell you whether you qualify. If you are unsure, please ask your GP or another health professional before you sign.

Please complete the highlighted fields before sending.

Who is this declaration for? I am the person with the condition I am completing this for someone else (for example as their parent, guardian, partner or carer)

Full name of the person with the condition

Please enter their full name.

Your relationship to them

Please enter your relationship.

Your details

Full name

Please enter your full name.

Address line 1

Please enter your address.

Address line 2 (optional)

Town or city

Please enter your town or city.

Postcode

Please enter your postcode.

Email address Please use the same email address as your order.

Please enter a valid email address.

Phone (optional)

Order number (if you have already ordered)

Medical reason for VAT relief

The person named above is chronically sick or disabled because of Name the long-term condition or disability, for example lymphoedema, lipoedema, chronic venous insufficiency or a limb amputation.

Please describe the condition.

Products this declaration is for List the products you are buying, or write "all eligible products in my order".

Please list the products.

Declaration

The products are for the personal or domestic use of the person named above.

Please confirm this statement.

The products are not for use in, or supplied through, a hospital, nursing home or care home where the person is a patient or resident.

Please confirm this statement.

The information I have given is true. I understand that it is an offence to make a false declaration.

Please confirm this statement.

Signature (type your full name)

Please type your name to sign.

Date

Please enter the date.

We keep this declaration with our VAT records as HMRC requires. Your health information is used only to apply VAT relief and is handled in line with our privacy policy.