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Carer Registration form

Carer Registration/Consent/Referral with your GP Surgery – Explanatory Note

Are you a Carer?

Do you look after a relative, friend or neighbour who is ill, frail, disabled, has a mental health concern or problematic substance use and who could not manage without your help?  If so, then you are a Carer and there are a number of ways you could get help and support.  The first step is to take a few moments to read this note and complete the form on the reverse of this sheet.

Why you should complete the Carer Registration Form

Your Surgery is part of the Investors in Carers (IiC) scheme aimed at making sure Carers receive health-related support.  You should have been given a copy of the Investors in Carers leaflet along with this registration form.  The leaflet provides more detail on the benefits of registering as a Carer.

If you complete Section A of the form the Surgery will record you as a Carer and be aware of this when dealing with you. It is also helpful to know who you are caring for and provided the person is in agreement, they should also complete a separate ‘Cared For’ consent form.  The Surgery will have a copy of this form.

Section B shows other forms of help available to Carers.  These are:

  • Carer’s Gazette Newsletter – The Pembrokeshire Carers Gazette is a free quarterly newsletter through which we pass information to Carers on services, details of events and issues that may concern them and the person(s) they care for.  Your details will be held on a confidential database held by the Carers Information & Support Service and will not be shared with third parties.
  • Pembrokeshire Carer Information Pack – containing information on a range of topics that will help you with your caring role including practical help, benefits and legal matters.  There are contact details for other organisations that may be able to offer support to you and/or the person(s) you care for.
  • Carers Information & Support Service – Our team of Support staff provide information and support to carers. An appointment with an Outreach worker, who can meet you in your own home, or at a preferred location, provides a listening ear and can help to prioritise your needs and better manage the impact of your caring role. They can also help you access other support services.

For further information about any of the above, please contact the Carers Information & Support Service on 01437 611002 or email


Carers providing or intending to provide care for someone can request a Carers Assessment from social care. For more information please contact the Carers Information & Support Service on 01437 611002 or email



What happens when you hand the completed form back to a member of surgery staff?

Once a member of staff from the surgery has checked that you have completed Sections A and/or B, you will be asked to sign the bottom of the form.  The member of staff will also sign the form.


The Surgery will then add your Carer details to its database so that all staff know that you are a Carer and should receive appropriate advice and support.