Unpaid Carer Registration Form

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Carer Registration

Does someone at home or in the community rely on you to help them get by? If so, you may be an unpaid carer and have a right to access support for yourself.

Telling your GP about your caring role can help make sure you get the support and help you need. Please fill in the following form to notify us you are a carer for someone.

Please provide your details via this form if you would like your unpaid carer status to be recorded in your medical records and your name added to the practice’s Carers Register. If the patient with an unpaid caring role is under 16, this form should be completed by their parent/ guardian.

If your caring situation changes in the future, please make the surgery aware.

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All questions marked with a * are mandatory

Your Details
Please double check you've entered the correct email address
(If above patient is under 16, parental/ guardian signature)
May be used to identify you
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Details Of Person Being Care For
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Privacy Consent

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