National Carers Card Application Form

Apply for a Merton National Carers Card
First Name*
First Name of Carer
Last Name*
Last Name of Carer
E-mail*

Confirmation Emailexample@example.com
Phone Number*
In case we need to contact you about your application.

Carer's Date of Birth
Day of Birth:*
The day of the carer's birth eg 12.
Month of Birth:*
The month of the carer's birth.
Year of Birth:*
The year of the carer's birth.

Apply for a Merton National Carers Card
Photo of Carer:*
Photo of Carer

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Where possible, your photo should:

• be facing forwards and looking straight at the camera

• have your eyes open and visible

• not have a head covering (unless it’s for religious or medical reasons)

• not have anything covering your face (unless for medical reasons)

• contain no other objects or other people (unless for medical reasons)

We understand that some circumstances may make these guidelines impractical, in which case simply provide the clearest photo you can.

Emergency Contacts
We offer the option to include an emergency contact on your card. If you choose to provide this information, the QR code on the back of your card will direct to your designated emergency contacts phone numbers.

If you choose not to have an emergency contact, the QR code will simply link to our website.
Would you like an Emergency Contact QR code printed on your card?*

YesNo

Emergency Contact
Your emergency contact's number will be stored in a QR code on the back of your ID card this allows quick access without needing a data connection or login in an emergency.

Please enter the phone number exactly as it should be called. If it is not a UK number please also include the country code (e.g., +353).
Emergency Contact's Phone Number:*
I have double-checked the accuracy of the emergency contacts phone number provided. I understand that if the number is incorrect, or if I need to change it in the future, I will be required to pay an administration fee and complete a replacement card form.
I confirm that I have obtained consent from the individual whose phone number is listed as my emergency contact. They are aware and consent to their phone number being encoded onto the physical ID card in the form of a QR Code and understand that it cannot be altered. Additionally, they understand that this phone number will be stored in our secure database solely for the purpose of reissuing an ID card, should the need arise.

Emergency Care Plan (Optional)
If you were to become unexpectedly unwell or incapacitated, an emergency care plan can help ensure that the person you care for continues to receive safe and consistent support.

You have the option to upload a PDF copy of your emergency care plan. If submitted, the plan will be emailed to the emergency contacts you specified earlier in this form, but only if you have opted in to providing emergency contact details. Your contacts should already have the password, provided by you in advance, so they can access the plan quickly if needed.

To meet UK GDPR requirements and protect everyone’s privacy, the file must be encrypted with a password. You must also confirm that you have obtained consent from the person you care for and any other individuals mentioned in the document.

Uploading an emergency care plan is entirely optional. It is not required in order to apply for a Merton National Carers Card. However, if you choose to upload a care plan, please note:

Your application will be rejected if the file is not encrypted with a password.
If you would like to include a care plan, please upload it below.

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Address for Card Delivery
Address Line 1*
Address Line 2
City/Town*
County
Post Code*

Apply for a National Carers Card
I agree to the Terms & Conditions found at https://www.disabilityid.co.uk/terms-and-conditions
I agree to the Privacy Policy found at https://www.disabilityid.co.uk/privacy-policy
I look after someone who needs help because of their illness, frailty, disability, a mental health problem or an addiction and they cannot cope without my support.

Checkout:*
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Merton National Carers Card
£ Free



Carers Lanyard & Holder
£5.00



Face Covering Exempt Lanyard & Holder
£5.00



RADAR KeyI certify that I am a carer and that the RADAR key will only be used in the performance of my duties as a carer.
£6.90 Quantity



Spare CardIf you require a spare duplicate copy of your card.
£10.00



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