Free resource
Free PIP Example Builder Worksheet
A calmer way to turn real-life difficulties into clearer notes before you fill anything in officially.
Many people know what they struggle with, but find it hard to write it down clearly. A useful PIP example usually explains what happened, what went wrong, what support was needed, and whether the activity was safe, reliable, repeatable and timely.
PIP Companion is not connected to the DWP and does not replace qualified benefits advice. It is a preparation workspace.
- Free worksheet
- 3 minute read
- For PIP preparation
What makes a useful PIP example?
A useful example is not about sounding polished. It is about explaining what actually happened, in plain words, so your notes are easier to understand later.
- What activity were you trying to do?
- What went wrong?
- Did anyone help, prompt or supervise you?
- Was there a risk?
- Could you do it safely?
- Could you do it repeatedly?
- Did it take much longer than expected?
- What happened afterwards?
- How often does this happen?
Copy this simple worksheet
Use this as a starting structure for your own real-life notes.
When I try to [activity], I struggle because [reason]. This means [what goes wrong]. The risk is [risk or safety issue]. I need [help, prompting, supervision or an aid] because [why]. This happens [how often]. A recent example was [real-life example]. Afterwards, [what happened next, such as pain, fatigue, distress, confusion or needing to rest].
You do not need to make this sound perfect. Start with plain notes. You can tidy them later.
From vague to clearer
Small details can make a note easier to understand.
Too vague
"I struggle cooking."
Clearer example
"Due to poor concentration, fatigue and memory difficulties, I often lose track of steps when preparing food. I have left food unattended while cooking, which creates a risk of burns, fire or undercooked food. I usually need prompting or supervision to prepare a simple meal safely. Last week, I left a pan on the hob and only realised when another person came into the kitchen."
This is only an example of structure. Your notes should describe what actually happens to you.
Remember the reliability questions
When preparing notes, it can help to think about whether the activity can be done in these ways. This is preparation guidance, not legal advice.
- Safely
- To an acceptable standard
- Repeatedly
- Within a reasonable time
Keep examples as they happen
Real examples are easier to remember if you write them down soon after they happen. Evidence notes can include date, activity, what happened, support needed, risk, and aftermath.
PIP Companion includes an evidence diary for saving these notes.
Ready to organise your PIP preparation notes?
Use PIP Companion to build your claim notes section by section, save real-life examples, collect evidence notes and export a preparation summary before completing anything officially.