Requesting a BASRiS form

The 'allow list' in this guidance was formerly known as 'whitelist'.

The BASRiS form gives confirmation of an individual’s terminal illness for the purpose of accessing disability assistance benefits in Scotland.

If you have access to the Scottish Wide Area Network (SWAN) on an NHS network, you can complete a BASRiS web form. If you do not have access to SWAN you should use an editable PDF BASRiS form or a paper BASRiS form.

A new version of the BASRiS form was released on 15 December 2022. Please ensure you use the most up to date form.

The new form states that the date to be provided is the date the clinical judgement of terminal Illness was made. You should complete the BASRiS as soon as you make the clinical judgement, but if you complete it on a later date, you must record the exact date on which you made the clinical judgement.

Paper BASRiS forms completed by hand must be posted. Send a completed paper BASRiS form to:

BASRiS
PO Box 27165
GLASGOW
G4 7BR

Old BASRiS forms that do not explicitly ask for the Date of Clinical Judgement of Terminal Illness should not be used.

Request paper forms

If you're a medical practitioner you can ask for paper BASRiS forms by filling out the form below. If you're an applicant and think you need a BASRiS, you should ask a medical practitioner for one.

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