Guidance

Example - PIP1 claim form

Find a sample form and additional information for Personal Independence Payment (PIP) claimants who need extra help to make a claim.

Applies to England, Northern Ireland and Wales

Documents

PIP1: claim form (for reference only)

Details

The quickest way to make a claim for Personal Independence Payment (PIP) is by phone or online. However, where an individual cannot call us, or needs extra help and has no one to support them making a claim by telephone, we can send them a form to fill in.

The PIP1 claim form captures the same basic information we take over the phone. It is sent along with PIP1 A1: additional information.

How to claim PIP

Our PIP guidance explains how to make a claim. If you need the form to be sent to you in a different format, call the PIP helpline.

Published 3 September 2013