Are you aged 65 or over? *

Yes

No

Which country do you currently live in? *

Select an option

Were you living in the EU, EEA or Switzerland before 1 january 2021? *

Yes

No

Not sure

Have you previously lived or worked in the UK? *

Lived and worked there

Lived there but did not work

Neither

Not sure

Do you need help with personal care or supervision because of a health condition or disability, even if nobody currently helps you? *

Yes, Regularly

Yes, Sometimes

No

Not Sure

Examples may include: Help with washing, moving around the house, dressing, using the toilet, taking medication or staying safe.

Which UK benefits do you currently receive? *

State Pension

Attendance Allowance

PIP

DLA

None

Not sure

common.other_option

Are you caring for someone else 35+ hours a week?

Yes

No

Sometimes

Full Name *

Email *

Phone *

When is the best time to contact you?

Select an option

I would like Reginald Barry Benefits Support to contact me by phone or email about my Attendance Allowance Enquiry

I explicitly consent to Reginald Barry Benefits Support using the health and care needs information i provide to assess my potential eligibility for Attendance Allowance, as explained in the Privacy Policy. I can withdraw my consent at any time by emailing [email protected]

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