Somerset County Council
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Deprivation of Liberty Safeguards

Please only use this form if you believe that the care or treatment the person requires might amount to depriving them of their liberty and you believe they lack mental capacity to consent to these arrangements.

This form is only for DoLS applications which are the responsibility of Somerset County Council.
Only complete this form if one of the following statements is true:

  • You are applying from a hospital and the patient usually lives at a Somerset address (own home or a care home)

  • You are applying from a care home (anywhere in England or Wales) and Somerset County Council pays all or part of the fees

  • You are applying from a care home in Somerset and the resident is self-funding or being paid for by their relatives

If the resident’s care is paid for under Continuing Health Care please contact the DoLS team for advice about which local authority will be responsible for processing the application. You will need to know where they were living before moving into the care home.

If you have already made an application and just wish to provide the DoLS team with additional information such as about a change in a person’s care needs or an emerging objection, please e-mail the DoLS team directly and do not make a new application

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Fields marked with * are mandatory and must be completed

Request a Standard Authorisation and Grant an Urgent Authorisation
  1. To help us decide what information we require from you please choose one of the following statements: *

Please provide your email address
  1. This email address will be used to forward confirmation and a copy of your application to you.
  2. Please provide a 2nd email address if your organisation also require the notification of the application process to be sent to a second person?