• Carer Registration Form

    • To view our registration pack, please click this link.
    • You can also take a look at our general information leaflet to find out more about the supports that we provide to carers – click here.
    • Did you know that we can also complete an Adult Carer Support Plan (ACSP) with carers? An ACSP starts with a conversation where you discuss your caring role and what is important to you in your life. To find out more about ACSPs, please click here.
    • To complete this registration form, please click 'Next' below.

  • Your Details

  • Date of Birth *
     / /
  • My employment status is:
  • My education status is:
  • Does the person you care for live in the same home as you?*

  • Your Health

  • Do you have a disability or long-term health condition?*

  • Your Caring Role

  • How long have you been caring?*
  • Approximately how many hours a week do you spend caring or providing support?*
  • Please select the type of care you provide:*

  • The Person You Care For

    Please provide details of your caring role.

  • How many people do you provide care to?

  • Person 1

  • Date of Birth (if known):
     / /
  • Age Range:
  • Does the person you care for live in the same local authority as you?*
  • Does the person you care for know that you are contacting the Carers Centre?*
  • Does anyone else (friend, family member) provide informal care to this person?*

  • Person 2

  • Date of Birth (if known):
     / /
  • Age Range:
  • Does the person you care for live in the same local authority as you?*
  • Does the person you care for know that you are contacting the Carers Centre?*
  • Does anyone else (friend, family member) provide informal care to this person?*

  • Person 3

  • Date of Birth (if known):
     / /
  • Age Range:
  • Does the person you care for live in the same local authority as you?*
  • Does the person you care for know that you are contacting the Carers Centre?*
  • Does anyone else (friend, family member) provide informal care to this person?*

  • Person 4

  • Date of Birth (if known):
     / /
  • Age Range:
  • Does the person you care for live in the same local authority as you?*
  • Does the person you care for know that you are contacting the Carers Centre?*
  • Does anyone else (friend, family member) provide informal care to this person?*

  • How can we help?

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  • Your Information and Your Preferences

    On receipt of this form, you will be registered as a carer with the Carers Centre, and information provided on this form will be recorded on the Centre’s computerised information system.  All information will be treated as strictly confidential, kept securely and not shared without your consent or knowledge, except under exceptional circumstances.

    Information Sharing

    As part of the Carers (Scotland) Act 2016, we are required to provide data to the Scottish Government for the annual Carers Census. This is for statistical and research purposes only and statisticians/researchers will not be able to identify individual carers from the data that they will use.

    To ensure that carers receive the support they require, the Carers Centre may need to share relevant information with other agencies on their behalf. Only the minimum information required will be shared, and only with those people who need to know. If the Carers Centre does this, it will only be with the carer’s knowledge and consent.

    Further information is contained in the Carer Registration Pack leaflet and our Privacy Notice which is available from the Carers Centre and on our website.

    Consent

    In order to provide one-to-one support to carers who contact the Carers Centre, or who are referred to the Centre by a third party, it may be necessary to contact you by phone or by post.  If you are also happy for us to contact you by email or text, please tick as appropriate:

  • You may also contact me by:
  • I also agree to:
  • Should be Empty: