Request a Blue Badge application pack

You can ask for an application pack by completing the online request form.


We'll then send you an application form by post.

This form should only be used to request an application pack for a new blue badge. If you need to renew your badge, a renewal form will be sent to you before expiry of your current badge.

Note: Asterisks (*) indicate required information.

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Request an application form




















Application pack details








If you experience any problems with this form please contact contact.centre@derbyshire.gov.uk and quote form ID: ILF/87/09