Carers

Are you caring for or supporting a relative, friend or neighbour? Are you helped or supported by a relative, friend or neighbour?

We need to know so we can offer you the right information, support and access to services.

We apologise for the detail required, which may not seem relevant, however careers can qualify for some extra benefits and we  need to collect this information before the  government can assess your situation. You can help us do this by completing the form below.

Find out more about help with day-to-day living with illness or disability on the NHS website.

About you

Your title(Required)

Your name(Required)
Your date of birth(Required)
Your email address(Required)
Have you ever worked in the military?(Required)

Details of person being cared for

Title of the person you are caring for(Required)

Name of the person you are caring for(Required)
Date of birth of the person you are caring for(Required)
Please tell us if you are related, a friend or other connection.
Is the person you care for a patient at this surgery?(Required)
Has the cared for person ever worked in the military?(Required)
Would you like to be referred to Action for Carers?(Required)
Not for urgent medical help(Required)
Consent(Required)

Date published: 20th September, 2023
Date last updated: 21st January, 2024