When you fill in a form, you provide us with personal data. You have rights related to this information.
You can learn more about your rights or how to request access or erasure of your personal data on our
Privacy Notice page.
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: