This questionnaire is designed to help us understand how your mental health affects your daily life and your ability to navigate. This information will be used to write a supporting document for your Personal Independence Payment (PIP) claim. Please provide as much information as possible, being as honest and detailed as you can. Think about how things are for you most of the time (more than 50% of days). Provide specific examples whenever possible – describing a typical or challenging day can be very helpful. There are no right or wrong answers; we need to understand your personal experience. Please take breaks as required while completing this.

This form should take approximately 30 minutes to complete. Take breaks, but do not close the page, as your information will be lost.