Blank Pip Form PDF Details

Most people use pip to install Python packages. It is one of the most popular programming languages in the world, and it's free! Pip does not fulfill all installation needs though. This blog post introduces you to Blank Pip Form, a tool that helps you create your own custom python distribution. You can then upload this distribution anywhere on the internet for other people to download and execute code with your custom package management system without needing any other tools or setup! The article also goes into detail about how you might want to use this tool in various situations like education, research labs, startups etc.

You will see info about the type of form you wish to fill out in the table. It can tell you how long it will take to fill out blank pip form, exactly what parts you will need to fill in, and so forth.

QuestionAnswer
Form NameBlank Pip Form
Form Length37 pages
Fillable?No
Fillable fields0
Avg. time to fill out9 min 15 sec
Other namespip form, dwp pip application form download, pip application form pdf, pip application form download pdf 2020

Form Preview Example

Personal Independence Payment

How your disability affects you

Full name

National Insurance (NI) number

only

Please fill in this form and return it to us straightaway.

We’ve sent you an Information Booklet to help you complete the

form. In the Information Booklet we:

If you need to ask for more time to compl te this form please call suse on 0800 121 4433 (0800 121 4493 if using a t xtphon ).

• give advice on where you can get help to complete the f rm

• explain the questions we ask

• tell you how to answer the questions, and

• give you examples of other things you can tell us

If you don't return this form to us and we don't hear from you to ask for more time to complete t, we ay end your claim to PIP.

If you don't want to ont nue w th your claim and w n’t be etu ning this form, please call us on 0800 121 4433 (0800 121 4493 if using a textphone).

What you n d to do

Step 1

– Read through this form and the Inf

rma ion Booklet.

Step 2

– Fill in this form (in pen) to tell us h

for

w y ur health condition

 

or disability affects you.

 

tep 3

– Read and sign the declarati n n page 32.

tep 4

– Return the form to us with photocopies of any additional

Specimeninformation. Not

PIP2 June 2018

1 of 33

Additional information to support your claim

As well as completing this form it is important that you help us to understand your needs by providing additional information. This should explain how your health condition or disability affects your daily life.

Do send information that shows how your health condition or disability affects you carrying out day-to-day activities.

Don’t send general information about your condition like fact sheets or information from the internet.

Only send us photocopies of information you already have available to you. We can’t return any documents to you.

There is more information, including examples of what to send us in the Information Booklet we sent you with this form.

only

Please put your name and National Insurance number

n the t p f

use

each document.

 

 

 

 

 

Specimen

 

Section 1 – About your health prof ssio

als

 

If we need additional information we may contact the h

alth professionals that upport you.

Q1 Tell us about the professional(s) best placed to advise s on how your health condition or d sab l ty affects you

For example, a GP, hospital doctor, spec alist nurse, community psychiatric nurse, occupational

therapist, physiotherapist, so

al worker, counsell

r, r supp t w

ker.

Name

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

for

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Postcode

Profession

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone number including the

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

dialling code

 

 

 

 

 

 

When did you last see them?

 

 

 

 

 

 

/

/

 

 

(approximate date)

Not

 

 

 

 

 

 

 

 

PIP2 June 2018

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Section 1 – About your health professionals continued

Name

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Postcode

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Profession

 

 

 

 

only

 

 

 

 

 

 

 

Phone number including the

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

dialling code

 

 

 

 

 

 

 

When did you last see them?

 

 

 

 

 

 

 

/

/

 

 

 

(approximate date)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Specimen

 

 

 

Name

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Po tcode

Profession

 

 

 

 

 

 

 

Phone number including the

 

 

for

use

dialling code

 

 

 

 

 

 

 

When did you last s th m?

 

/

/

 

 

 

(approximate dat )

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Not

 

 

 

 

If you need to add more please c

ntinue at Q15 Additional information.

PIP2 June 2018

3 of 33

Section 2 - About your health condition or disability

iUse page 7 of the Information Booklet to help you answer these questions.

Q2a - Tell us in the space below:

what your health conditions or disabilities are, and

approximately when each of these started

 

 

 

 

Health condition or disability

 

only

 

 

Approximate start date

 

Example: Diabetes

 

May 2010

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Specimen

 

 

 

for

 

We will ask you how your health ond t ons or disabilities affect h w useyou

carry out day-to-day a tivities in the rest of the

rm.

If you need to add more pl ase ontinue at Q15 Additional inf rmation.

Not

 

 

 

PIP2 June 2018

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Section 2 - About your health condition or disability continued

Q2b - Tell us about:

tablets or other medication you’re taking or will be taking and the dosage

any treatments you’re having or will be having, such as chemotherapy, physiotherapy or dialysis

any side effects these have on you

 

only

Specimen

use

Not

for

 

If you need to add more please continue at Q15 Additional information.

PIP2 June 2018

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Section 3 - How your health condition or disability affects your day-to-day life

Tell us in the rest of this form how your health conditions or disabilities affect your day-to-day activities.

Q3 - Preparing Food

i Use page 7 of the Information Booklet to help answer these questions.

Tell us about whether you can prepare a simple one course meal for one from fresh ingredients.

This includes things like:

 

 

 

 

 

 

food preparation such as peeling, chopping or opening packagi g, a d

safely cooking or heating food on a cooker hob or in a microwave oven

Tick the boxes that apply to you, then provide more informati

in the

Extra information box.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Specimen

 

Q3a - Do you need to use an aid

 

Yes

 

only

 

or appliance to prepare or

 

No

 

 

cook a simple meal?

 

 

 

 

Aids and appliances

 

 

Som tim s

 

 

 

include things like:

 

 

 

 

 

 

 

• perching stools,

 

 

 

 

 

 

 

lightweight pots and

 

 

 

 

 

 

pans, easy grip handles

 

 

for

 

 

• do they remind or

 

 

 

 

 

on utensils, single lever

 

 

 

 

 

 

arm taps and liqu d level

 

 

 

 

 

 

indicators

 

 

 

 

 

 

 

Q3b – Do you n

d h lp from

 

Yes

 

 

 

 

anoth r

rson to pr pare

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Not

 

 

 

 

or cook a sim le m al?

 

No

 

 

 

 

By this we m an:

 

 

S me imes

 

 

 

motivate you to cook?

 

 

 

 

 

 

• do they plan the task f r

 

 

 

 

 

 

you?

 

 

 

 

 

 

 

 

• do they supervise you?

 

 

 

 

 

 

• do they physically help

 

 

 

 

 

 

you?

 

 

 

 

 

 

 

 

• do they prepare all your

 

 

 

 

 

 

food for you?

 

 

 

 

 

 

 

This includes help you

 

 

 

 

 

 

have, and help you need

 

 

 

 

 

 

but don’t get.

 

 

 

 

 

 

PIP2 June 2018

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Q3c - Extra information - Preparing Food

Tell us more about any difficulties you have when preparing and cooking food:

• tell us how your condition affects you doing this activity

 

 

 

tell us how you manage at the moment and the problems you have when you can't

 

do this activity

 

 

 

 

tell us how long it takes to prepare and cook food

 

 

 

does whether you can do this vary throughout the day? Tell us about good and bad

 

days

 

only

can you cook using an oven safely? If not, tell us why not

tell us about the aids or appliances you need to use to help you prepare and cook

 

food

 

 

 

 

do you experience any other difficulties, either during or after the activity, ike pain,

 

breathlessness or tiredness?

 

 

 

 

tell us about the help you need from another person when prepari g f od. This

 

includes help you have and help you need but don't get

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

use

 

 

 

 

 

 

 

 

Specimen

 

 

 

 

 

for

 

 

 

 

 

 

 

 

Not

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If you need to add more please continue at Q15 Additional information.

PIP2 June 2018

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Q4 - Eating and drinking

iUse page 7 of the Information Booklet to help answer these questions.

Tell us about whether you can eat and drink.

This means:

remembering when to eat

cutting food into pieces

putting food and drink in your mouth, and

chewing and swallowing food and drink

 

 

 

 

 

 

only

Tick the boxes that apply to you, then provide more information in the

Extra information box.

 

 

 

 

 

 

Q4a – Do you need to use an aid

 

Yes

 

 

 

or appliance to eat and

 

No

 

 

 

drink?

 

 

 

 

 

 

Aids and appliances

 

 

Sometimes

 

 

 

 

 

 

include things like:

 

 

 

use

 

 

 

 

 

Specimen

 

 

• weighted cups, adapted

 

 

 

 

 

cutlery

 

 

 

 

 

 

 

Q4b – Do you use a feeding tube

 

Y s

 

 

 

or similar device to eat

 

No

 

 

 

or drink?

 

 

 

 

 

 

This means things l ke a

 

So eti es

 

 

feeding tube with a rate

 

 

for

 

limiting devi e as a

 

 

 

 

 

 

delivery system or feed

 

 

 

 

 

pump.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q4c – Do you n

 

Not

 

 

 

d h lp from

 

Yes

 

 

 

anoth r

rson to at and

 

No

 

 

 

drink?

 

 

 

 

 

 

By this we mean:

 

 

S metimes

 

 

• do they remind you to eat

 

 

 

 

 

and drink?

 

 

 

 

 

 

• do they supervise you?

 

 

 

 

 

• do they physically help

 

 

 

 

 

you to eat and drink?

 

 

 

 

 

• do they help you manage

 

 

 

 

 

a feeding tube?

 

 

 

 

 

 

This includes help you have and help you need but don't get.

PIP2 June 2018

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Q4d - Extra information - Eating and drinking

Tell us more about any difficulties you have when eating and drinking:

• tell us how your condition affects you doing this activity

 

 

 

tell us how you manage at the moment and the problems you have when you can't

 

do this activity

 

 

 

 

tell us how long it takes you to complete this activity

 

 

 

does whether you can do this vary throughout the day? Tell us about good and bad

 

days

 

only

 

 

 

 

 

do you experience any other difficulties, either during or after the activity, ike pain,

 

breathlessness or tiredness?

 

 

 

 

tell us about the aids and appliances you need to use to help you eat and drink

tell us about the help you need from another person when eati g a d dri ki g. This

 

includes help you have and help you need but don't get

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

use

 

 

 

 

 

 

 

 

Specimen

 

 

 

 

for

 

 

 

 

 

 

 

 

Not

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If you need to add more please continue at Q15 Additional information.

PIP2 June 2018

9 of 33

Q5 – Managing treatments

iUse page 8 of the Information Booklet to help answer these questions

Tell us about whether you can monitor changes in your health condition, take medication or manage any treatments carried out at home. Monitoring changes include things like:

• monitoring blood sugar level, changes in mental state and pain levels

A home treatment includes things like:

 

 

only

 

 

 

 

• physiotherapy and home dialysis

 

 

 

 

Tick the boxes that apply to you then provide more information in the Extra

information box.

 

 

 

 

 

 

 

Q5a – Do you need to use an aid

 

 

Yes

 

 

 

 

 

 

 

 

or appliance to monitor

 

 

No

 

 

 

 

 

 

 

 

your health conditions,

 

 

 

 

 

take medication or

 

 

 

Sometimes

 

use

 

 

 

 

 

 

 

 

 

Specimen

 

 

manage home

 

 

 

 

 

 

 

treatments?

 

 

 

 

 

 

 

For example, using a

 

 

 

 

 

 

 

Dosette Box for tablets.

 

 

 

 

Q5b – Do you need help from

 

Y s

 

 

 

another person to

 

 

 

No

for

 

monitor your health

 

 

 

 

 

 

conditions, take

 

 

 

So eti es

 

 

medication or manage

 

 

 

 

 

home treatments?

 

 

 

 

 

 

 

By this we m an:

 

 

 

 

 

 

 

• do th y r mind you to

 

 

 

 

take m dications and

 

 

 

 

treatm nt?

Not

 

 

 

 

 

 

 

 

 

 

• do th y su rvise you while you take your medication?

• do they physically help you take medication or manage treatments?

This includes help you have and help you need but don't get.

PIP2 June 2018

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