Personal Independence Payment (PIP) Request - Abertillery Group Practice

Personal Independence Payment (PIP) is extra money to help you with everyday life if you’ve an illness, disability or mental health condition.

You can get it on top of Employment and Support Allowance or other benefits. Your income, savings, and whether you’re working or not don't affect your eligibility.

To request supporting evidence from your GP surgery, please complete the form below

Your details

Full Name

Date of Birth

Address to include Post Code

Telephone Number

Email Address

About your application

What data are you requesting?

Please provide as much detail as possible as to the data you are requesting, include time periods and specific episodes of illness or treatment wherever possible.

Identification

In order, to protect your information, we are unable to respond to a request unless we have confirmed your identity. Please provide one form of identification and one proof of address.

Documents that can be used as proof of current address (must be dated in the last six months)

Please upload the relevant document as proof of address

Please upload the relevant document as proof of identity

I confirm I am a registered patient at Abertillery Group Practice, Ground Floor – The Bridge Centre, Foundry Bridge, Abertillery.

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