Register a Carer

It is important that we know if you are a carer so that we can make sure you receive information, services and the help that is available. It is important your doctor is aware of the extra support you provide to others.

We may ask you to keep your details up to date on a regular basis – you can use this form to update your contact details, to tell us if your carer status changes, or if the condition of the person you care for changes.

Tell us what support you need

We cannot guess at what might help you, but we can connect you with Action for Carers Surrey who can provide free independent information, advice and support to carers of all ages across Surrey.

We can refer you for the following services:

  • Carers Information Pack
  • Carers Support
  • Young Carers Support
  • Carers Break (requires approval from your GP) (What is this?)

When completing this form, select the box ‘Would you like to be referred to Action for Carers’ to select your support needs.

Register a Carer

Register a Carer

Carer Details

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.
Is the person you care for a patient at this surgery?
Would you like to be referred to Action for Carers?

Action for Carers can support you by phone, through face-to-face meetings, support groups and workshops. They can help with benefits advice, advocacy, give practical guidance on moving and handling, and provide a wealth of information and free resources. They can also signpost you, and the person you care for, on to relevant specialised sources of support.

Action for Carers

Please indicate which of the following support options best suits your needs:

For more information please visit the Action for Carers website:

Details of Person Being Cared For

Please use this date format: DD/MM/YYYY.