How to register

There are several ways to register as a carer:

You can fill in the form below or

You can email us at help@herefordshirecarerssupport.org with your contact details and we will be in touch to register you

or telephone us on 01432 356068 and our staff will go through the registration process with you

or download the following form and return it to: Herefordshire Carers Support Ltd., FREEPOST BRYX-KLUG-TJKR, Hereford, HR1 2EA.
Registration Form

You do not have to provide personal information to us, but it helps us in planning services. We will remove your details from our database at any time if you request it to be done. Contact our Data Controller for any queries regarding Data collection and handling.

Registration Form

* Indicate fields which must be completed

Mr Mrs Ms Other    First name:

*Surname:

Date of Birth:

Address:

*Postcode:

Email address:

*Telephone number:

Caring issues - please tick the following:
Parent Carer Mental Health Older People Learning Disability
Physical Disability Physical illness Other

Your GP Surgery:    

Name of Cared for:    

Relationship to Cared for:    

DOB of Cared for:    

Brief description of Cared for's health problems    

Please register me as a Carer. You do not have to provide personal information to us, but it helps us in planning services.

If you agree to your personal data being held and processed by Herefordshire Carers Support please tick the box below. We will remove your details from our database at any time if you request it to be done. Contact our Data Controller for any queries regarding Data collection and handling.

Tick box to accept:

Why Register?

So we can help you - if you are registered as a carer then we can provide you with the support you need through: -

• Signposting to a wide variety of other services
• Access to our Carers Group Meetings
• Involvement with developing services
• Our Emergency Card Scheme
• A regular newsletter
• Our Young Carers Scheme
• Our respite break scheme
• Social Events and outings
• Access to our support workers - there to listen, give support and practical advice.

You may feel you do not need these services at the minute, but please still register. The last census showed that there are about 17,500 carers in Herefordshire but only 3,000 are registered at the minute. It is vitally important that all carers register in order that services in the future can be planned. The more carers that are registered the stronger our voice will be to ensure that Carers:

• Are Recognised
• Are Valued
• Get Better Services