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PIP Claim Tribunal
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Intake form
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Name
*
Email address
*
What type of assistance do you require?
Please select at least one option.
Consultation
Representation at tribunal
No-win-no-fee options
Have you previously submitted a PIP claim?
Select
Yes
No
What is the current status of your PIP claim?
Select
Awaiting decision
Decision made
Appeal in progress
What is your preferred method of contact?
Please select at least one option.
Phone
Email
In-person
Please provide details about your PIP claim (e.g., date submitted, reasons for appeal)
What challenges have you faced in the PIP appeals process?
Are there any specific dates or deadlines we should be aware of?
Additional questions or comments
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