Form

How your disability affects you

An example 'How your disability affects you' form, as sent to Personal Independence Payment (PIP) claimants after the initial phone call.

Documents

How your disability affects you form

This file may not be suitable for users of assistive technology. Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email accessible.formats@dwp.gsi.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Welsh: Sut mae eich anabledd yn effeithio arnoch

This file may not be suitable for users of assistive technology. Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email accessible.formats@dwp.gsi.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Detail

This form is provided as an example for support organisations who work with disabled people. It illustrates the information that PIP claimants will be provided with and the questions they will be asked to answer and return to DWP, following their initial call to the PIP claims number. It is not intended to be downloaded and completed. Claimants will be sent a personalised version of the form by post as part of the claims process.