Carer Registration Form

If you prefer, you can print a PDF version of this form, fill it in by hand and then send it to the practice.

The Patient

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I give consent for my health needs, medication and treatment to be disclosed by my GP to my carer if they believe that this would be of benefit in providing my care.
I give consent for my details to be provided to Social Services in order that they can arrange an assessment of my needs.
I wish to discuss my care needs with my GP.

The Carer

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I wish to discuss my needs as a carer with my GP.
I give consent for my details to be provided to Social Services in order to have an assessment of my needs as a carer.

Swindon Carers Centre is a local Princess Royal Trust organisation based in Sanford Street, which provides advice and support for carers in Swindon.

I would like to receive an information pack from Focus.
 

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If you would prefer to contact the Carers Centre directly their details are:

Swindon Advice and Support Centre
Sanford Street
Swindon
Wiltshire
SN1 1HE
Tel: 01793 531133

www.carers.org/swindon