Eligibility - Kinly

Attendance Allowance

Check your eligibility

If completing this form for a friend or relative, please complete all fields for the person seeking Attendance Allowance support. You can add your name as the referrer. You do not need to complete all information, please note that some fields are marked as optional.

Name

Referrer Name (if completing for a friend/relative)

Phone number

Are you over 66 years old?

Have you previously applied for Attendance Allowance?

Are you currently claiming any of the following: PIP, DLA or Attendance Allowance?

Are you a British citizen and have you lived in UK for at least two of the past 3 years?

If applicable, please tell us about any other conditions not listed above

Have you had at least one of those conditions for the last 6 months?

As a result of these conditions, do you have difficulty (or need help) doing any of the following daily activities: (please tick any that apply)

Getting in or out of bed

Getting to or using the toilet

Washing, bathing, showering or grooming

Dressing and undressing (socks, shoes, zips, buttons)

Moving around indoors or getting up/down the stairs

Eating and drinking

Taking or remembering medications

Communication (memory, hearing or understanding things)

Do you stumble regularly?

Have you had a fall in the past few years?

Are you currently in hospital?

Are you currently in a care home (self-funding)?

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Attendance Allowance

Check your eligibility

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