| 1 | Health professionals | The people who know your condition best: GP, consultant, nurse, therapist, support worker. Their details let the DWP ask them for evidence. |
| 2 | Conditions, medication and treatment | Every physical and mental health condition, when it started, medication with doses, and treatments, plus side effects. |
| 3 | Preparing food | Peeling, chopping, using the hob or microwave safely, lifting pans, remembering what you're doing, motivation to cook. |
| 4 | Eating and drinking | Cutting food, getting it to your mouth, chewing, swallowing, needing reminders to eat, feeding tubes. |
| 5 | Managing treatments | Remembering medication, getting the right dose, noticing changes in your condition, therapies at home and how long they take each week. |
| 6 | Washing and bathing | Getting in and out of the bath or shower, washing your hair and body, safety, how long it takes, whether someone needs to be nearby. |
| 7 | Using the toilet and incontinence | Getting on and off the toilet, cleaning yourself, accidents, pads, catheters, stomas. |
| 8 | Dressing and undressing | Buttons, zips, shoes and socks, choosing clothes suitable for the weather, motivation to get dressed. |
| 9 | Talking, listening and understanding | Speaking, hearing, understanding what's said to you, needing someone to explain or repeat things. |
| 10 | Reading | Reading signs, symbols and letters, and understanding them. Not about learning to read. |
| 11 | Mixing with other people | Meeting people face to face, anxiety, distress, behaviour, needing someone with you. |
| 12 | Managing money | Understanding prices, change and bills, budgeting, impulsive spending. |
| 13 | Planning and following journeys | Familiar and unfamiliar routes, getting lost, anxiety or distress when going out, needing someone with you. |
| 14 | Moving around | How far you can walk, at what pace, with what aids, what happens when you stop. A double-decker bus is about 10 metres long. |
| 15 | Additional information | Anything else: how your condition varies, bad days, sleep, pain, fatigue, anything that didn't fit elsewhere. |