This questionnaire is posed to an applicant diagnosed with Diffuse Mesothelioma. If you are completing it on their behalf, or as their dependant, please answer the questions as though you are the person diagnosed with Diffuse Mesothelioma.
If you have responded Yes to each question you may be eligible to apply to the scheme.
As the information will prove to be of use when completing your application form, we recommend that you read our Application and Appeals Process, FAQs and Glossary & Useful Links pages.
Once your application form is completed and all relevant supporting documents and information are available, please submit this to us via this website, by email at DMPS.CM@davies-group.com, or by post