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Request a Blue Badge Scheme Application Form

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Please complete all fields marked *. Hover your mouse over anyExample of help marks for additional help.
If you would like to see how we use your personal data please read our privacy notice.

If you live in Surrey and you would like us to send you a printed application form for a new or renewal blue badge, please submit your details on the form below. Please be aware this does not constitute an application in itself but it only requesting us to send you a printed form. A quicker and more direct way is to apply online at

Please note we can only deal with requests from Surrey residents. We do not deal with residents who pay their council tax to other issuing authorities such as Richmond, Kingston or Sutton.

Note: If your local district or borough council isn't in the above list then you are not based in the administrative area of Surrey. You should contact your local council rather than send your application to us.
All applicants should fill this section in.
Renewals - Previous address
Please give the address from which the last application was made if not the same as your current address.
If you have completed all the fields marked *, then please click "Submit".