Join our Community of Carers

Please note: If you are a healthcare professional referring a carer please use one of our referral forms for either the Universal or Carer Assessment service,

If you are a carer, please use this form to Join our Community of Carers:
This gives you access to a range of support and you’ll receive our monthly carers email newsletter. Once you’ve completed this form we’ll add your details to our database and send you a Welcome Pack with information about our support services, plus a Carer Card for you to access special discounts.

We need to collect some basic information about yourself and the person you care for to make sure you’re eligible to access our services and that we’re offering you the right support. When completing the form please make sure you answer all the compulsory questions marked with ’required’. We’ll process and record the personal data you supply on this form in accordance with our privacy notice

If you need help with the form please email: [email protected] or call 0114 278 8942.

SECTION 1: ABOUT YOU: These first set of questions are about you as the carer eg the person supporting a family member or friend

Your First Name(s) (required)

Your Surname (required)

Your Home Address (required)

Your Postcode (required)

Your Phone (landline and/or mobile) (required)

Can we leave a message and say where we are calling from? (required)

How did you hear about the Carers Centre? (please give name of GP surgery or other source)

Your Email Address

Your Date of Birth (required)

Do you have any accessibility needs or require any support to access our services? (required)

Your current employment status

SECTION 2: EQUALITIES MONITORING: We’re committed to equality of opportunity for everyone. These next questions help us ensure our services are as accessible as possible. Questions are optional and answers are only used for equal opportunities monitoring.

Your Gender

Your Sexual Orientation

Your Ethnicity

Do you consider yourself to be disabled?

SECTION 3: ABOUT YOUR CARING ROLE: These questions are about your caring role and the person(s) you look after. It’s important we know a little about the person(s) you help so we understand how best to support you in your caring role.

How long have you been in your current caring role? (required)

What is your relationship with the cared-for person? You are: (required)

Cared-for person’s First Name(s)?

Cared-for person’s Surname?

Cared-for person’s Address (required)

Cared-for person’s Postcode (required)

Cared-for person’s main condition or disability that you support? (required)

Cared-for person’s Date of Birth?

Is the cared-for person receiving support from Adult Social Care?

If you are a carer for more than one person complete and send this form, then complete another for the second person. If you are a carer for more than two people please call us on 0114 278 8942.

The information provided in this form will be collected and stored by Sheffield Carers Centre. We will always store your personal details securely and in line our Privacy Policy. Please tick the box below to confirm you understand. (required)

I understand

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