Renew your disabled person's bus pass form

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Renew your disabled person's bus pass form

Renew your disabled person's bus pass form

Please note if your Herefordshire Council issued concessionary bus pass will expire within the next 90 days, please complete this form and we will send you a new pass shortly before your old one expires. You can also use this form if your pass has already expired.

Your details

First name *

Last name *

Current address *

Postcode *

Have you moved since your card was issued? *

Yes
No

Previous address *

Postcode *

Telephone number

Date of birth *

Old concessionary pass number (last 8 digits) *

Disability details

Please check one box below to indicate your disability *

Blind or partially sighted
Severely or profoundly deaf
Without speech
Substantial and long term adverse effect on ability to walk
No arms or has long term loss of the use of both arms
Learning disability
Refusal of a driving licence

Upload documents

Upload any documents that will help with your request. Only the following file types can be uploaded: Word/pdf/jpg/gif/png. There is a 2mb limit per attachment.

Document One *

At least one supporting document must be uploaded.

Document Two

Document Three

Is a companion pass required? *

Yes
No

If your Herefordshire Council-issued Disabled person’s bus pass is marked with a ‘C’ to indicate that you have ‘Companion‘ entitlement, you can renew using this form. Please read the Companion bus pass page carefully and tick the box below before uploading evidence to confirm that you are eligible.

Companion pass required if eligible

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