Doctor’s Certificate (to be filled in by a registered medical practitioner)
Before completing this certificate, please read the guidance notes overleaf.

Full name of patient	Patient’s home address	
		
Name of person requesting a certificate
(if different to the above)	Address to which the certificate is to be returned (if different to the above)	

For council tax purposes, a person is severely mentally impaired if they have a severe impairment of intelligence and social functioning (however caused) which appears to be permanent.

Please give details as requested below.  When completed, this form should be returned to the applicant/person acting on behalf of the applicant

	In my opinion, the person named above is severely mentally impaired as a result  of the following condition(s):	
	…………………………………………………………………………........………………	
	and has been so since ……………………………….	
		
	In my opinion, the person named above does not meet the definition of severely mentally impaired for council tax purposes because:	
	……………………………………………………………………………………………….	

Doctor’s full name			
Official stamp	
						
Doctor’s signature		Date				
						
Telephone number				
				
Email address				

COUNCIL TAX REDUCTIONS FOR PEOPLE WITH
SEVERE MENTAL IMPAIRMENT

Guidance for registered medical practitioners

Households that include people suffering from severe mental impairment, including those with Alzheimer's or Parkinson's disease, those who have suffered a stroke, those with severe learning difficulties and those who have suffered such impairment as a result of injury, may be entitled to a council tax discount or exemption.
To give rise to a reduction, there has to be 
“a severe impairment of intelligence and social functioning (however caused) which appears to be permanent”.
and entitlement to at least one of a number of qualifying benefits.

The definition is not the same as the definition of “severe mental impairment” in the Mental Health Act 1983, and being classified as severely mentally impaired for the council tax purposes does not affect the right to vote or to be included in the electoral register, which is compiled separately.

The applicant (or person acting on his/her behalf) will pass a certificate to a general practitioner or other registered medical practitioner with knowledge of the applicant for completion.

A decision about the presence of severe mental impairment will, in all cases, depend on the doctor’s clinical judgment as to whether the applicant meets these criteria.

If a doctor is uncertain whether an applicant’s intelligence and social functioning are such as to constitute severe mental impairment he may wish to seek information and advice from the appropriate medical colleagues or from colleagues in other professions, or from carers who may be able to help with information based on their knowledge of the applicant. 

If, after such consultation, a doctor is still uncertain as to whether the applicant is severely mentally impaired he or she should not sign the certificate.

The certificate will need to be returned to the applicant so it can be sent back with the application form.

Please note that a charge cannot be made for this: https://www.bma.org.uk/advice/employment/fees/certificates-no-charge

The doctor may retain a copy of the certificate.