I wish to apply for a Freedom Pass from the London Borough of Barnet. I am a permanent resident of the London Borough of Barnet. I understand that it may be necessary to gain more information about my condition from my doctor. I agree to the London Borough of Barnet contacting my doctor for this purpose. I understand that my application may need to be assessed by the council's Occupational Therapist/Social Worker. If you were unable to complete the application yourself, it may be completed on your behalf by a relative/spouse/friend/person of authority.