(One child/young person per application form)
Home Address
Please note that this Scheme is only available for families within Bath & North East Somerset.
Child's Details
Please describe briefly your child’s/young person’s needs: (e.g. communication, mobility, continence, epilepsy, etc.)
Diagnosis Details
If a professional has given you a diagnosis of your child's condition, please state the condition and the name, address and status (e.g. Paediatrician, GP) of the professional
Further Details
Consent

This to ensure that you are a real person, and not a computer adding information automatically.