Register a Carer

We are setting up a register of people who are carers in this community, so that we may help you to access support and information services about being a carer.

All carer’s requirements need to be assessed, in order to do so we need to be able to provide information to Social Services on your behalf.

We are also looking to help you gain access to information for example about rest-bite, support groups, activity centres you can use and funding.

In order to assess what services you have and what services you may need I would be grateful if you could complete the form below.

If you have access to Social Services we would still like you to complete this form for our records.

Are You A Carer?

Do you look after a family member or friend who is unwell, disabled or frail?

If so, please complete this form. Once you are added to our list of carers we will know about your busy life as a carer, which can affect your health. We can also try and be flexible with appointments etc as we will know about your commitments.

Carer Details

Title
Name
MM slash DD slash YYYY
Address

Details of person being cared for

Title
Name
MM slash DD slash YYYY
Address
This field is for validation purposes and should be left unchanged.