Unpaid Carer Grant Application Form
HomaCare offers two Unpaid Carer Grants each month. The deadline for applications for grants to be used that month is the first Friday of the month. Form responses are encrypted and are never shared outside of HomaCare. For more details please see our Privacy Policy.
Name of person applying for Unpaid Carer Grant
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First Name
Last Name
Email
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Preferred email address of person applying for grant
Phone number
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Preferred phone of person applying for grant
Postcode of person requiring care
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Please provide only the postcode, not the full address
Please describe your current care commitments
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Such as general details of the person cared for, type of support required, frequency of support
Please describe the effect your current care commitments are having on your daily life
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Please tell us how you would spend your free time if you were relieved of your care commitments for a few days
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I confirm I meet all of the eligibility criteria listed above
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Yes
No
Optional: I would like to receive updates about other support services, news, and offers from HomaCare. (We will never sell your data to third parties).
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Yes
No
I consent to HomaCare processing the health and care information provided in this form for the purpose of assessing my eligibility for the Carer Grant. I confirm that I have the permission (or legal authority) to share the details of the person I care for. I understand I can withdraw this consent at any time.
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Please input your initials into the box to indicate explicit consent
Submit
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