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formola elettronika
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The below document is required to be filled in by your Doctor if you are applying for a Personal or Communal reserved parking space.
Doctor's Report
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Applicant Details
I am filling this form on behalf of the applicant
Mandatory fields are marked with an *
Person Related Full Name
Relation to the Person with the disability *
Person Related Contact Number
Type of Application *
Tip ta' Applikazzjoni *
ID Card/Passport No *
Blue Badge No *
Name & Surname *
Address *
Name of Street *
Locality *
Email *
Address of Summer Residence *
Type a value
Date of Birth *
...
Telephone No *
Mobile No *
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Please tick if you have a garage adjacent to your residence or requested reserved parking space
Reason for Application *
Attachments Section
Please note that both sides of the Disabled Blue Badge should be visible in the attachment.
Please Note That the interior of the log book should be visible in the attachment.
Copy of Disabled Blue Badge *
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Copy of Special Disabled ID Card *
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Copy of Log Book *
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Copy of Doctor's Report *
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Copy of EU Disability Card *
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Medical Certificate *
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Doctor's Declaration Filled in
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Doctor's Declaration Template
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Submission Copy
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Terms & Conditions
Prior to applying for this service kindly read to below document to confirm your eligibility.
Terms & Conditions
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Data Protection Privacy Notice
Id
Submission ID
Data Protection Privacy Notice
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