Register a Carer

It is important that we know if you are a carer so that we can make sure you receive information on the services and the help that is available. If you are a carer please complete this form.

Register a Carer Form

Register a Carer Form

With your permission, we will pass your details to the Gloucestershire Carers Hub, which is a local organisation providing relevant information, advice and access to a wide range of local support services.  They will be able to carry out a carer’s assessment with you, which is an opportunity to talk about your needs as a carer and the possible ways help could be given. It can also look at the needs of the person you care for. This could be done separately, or together, depending on the situation. There is no charge for an assessment.

We also invite all carer’s to have an annual review with their GP to make sure your own health needs are being met.

Carer Details

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.

Details of Person Being Cared For

Please use this date format: DD/MM/YYYY.
Is the person you care for a patient at this surgery?

Gloucestershire Carers Hub

Would you like to be referred to Gloucestershire Carers Hub? *

The Gloucestershire Carers Hub collect and use your personal information to provide carer support services effectively and to meet their statutory duties under the care act 2014 and other relevant legislation. They will collect your name and contact details as well as information relevant to your support needs. The Gloucestershire County Council and PeoplePlus privacy notice outlines the types of information they are required to capture, the reasons for this and the commitments to privacy regarding the information held.

Contact Preferences

Carers Caring Details

Is there anything specific you would like help with? Please tick all that apply:
Do you have any support currently in place?