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Attendance Allowance claim form (19 April 2021)
Form
Attendance Allowance claim form
- English
- Cymraeg
Use the Attendance Allowance claim form to apply for financial help for your personal care if you're disabled and State Pension age or older.
From:
Department for Work and Pensions
Published:
1 April 2013
Last updated:
19 April 2021, see all updates
Applies to:
Wales, England, and Scotland
Documents
Attendance Allowance claim form you can download, fill in on screen, save – and then print
Ref: AA1PDF, 550KB
Notes on how to fill in the Attendance Allowance claim form
Ref: AA1 notesPDF, 171KB
Notes on Attendance Allowance, Carer’s Allowance and Carer’s Credit
Ref: AA1 notes Carer's CreditPDF, 105KB, 2 pages
Details
Read more about Attendance Allowance before you apply.
Before you start this form
Use a PDF reader to open and fill in this form. You can download a free PDF reader from your app store or from the internet.
If you are using screen reader software to access the form, we recommend that you review all of the notes and the questions on the form before you complete it. As you complete the form, you will be guided through the questions based on the responses you provide.
Do not use your device’s browser or, if you are an Apple Macintosh user, the Preview application.
You can save data typed into this form if you use a PDF reader. This means that you do not have to fill in the form in one session.
There are reliability issues with some assistive software, which may mean the form will not save properly.
This form will only save if it is both:
- saved onto your computer
- opened in a recent version of PDF reader
The form will not save in:
- versions of Acrobat Reader older than version XI
- some other PDF readers, for example Preview on a Mac or Foxit on a PC
Help using this PDF claim form
For help and advice on the information you need to put on the form or about the benefit you want to claim, contact the Attendance Allowance helpline.
Contact the DWP Online Helpdesk, if you are having technical difficulties:
- downloading the form
- navigating around the form
- printing the form
DWP online helpdesk
Email dwponline.helpdesk@dwp.gov.uk
Telephone 0800 169 0154
Monday to Friday 8am to 6pm
Closed weekends and all public and bank holidays
Where to send the form
Send the completed form to:
Freepost DWP Attendance Allowance
You do not need a postcode or a stamp.
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, fill in the online accessible format request.
Published 1 April 2013
Last updated 19 April 2021 + show all updates