Are you a Carer Registration Form

If you are looking to register that you have a carer please complete the Do you have a Carer form

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Carer Registration

Do you care for someone?

If so, you may be a carer. 

Definition of a Carer:

A carer is anyone, regardless of age, who provides or supervises a lot of care. This is for a child, relative, partner, or neighbour. They cannot cope alone due to illness, disability, frailty, or mental impairment.

You could be a volunteer from a voluntary agency, a paid carer, or a family member. If this applies to you, please complete this form and return it to our Care Navigators.

By identifying yourself as a carer, we can support you. We can also direct you to available support services. If you consent, we will refer you to Adult Social Care for an assessment. They will identify your needs and support you as a carer.

If you are a carer please complete this form

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All questions marked with a * are mandatory

Your Details
Please double check you've entered the correct email address

Help Us To Help You 

Providing a NHS Number means that we can find a patient record more accurately, saving time and resources. 

How to find your NHS Number 

e.g. cooking, driving, shopping, personal care
May be used to identify you
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Details about the person you care for
Is the person you care for a patient at this surgery?:
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Privacy Consent

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