Carers Support Group Registration Form
Please fill out your details and indicate your caring role, challenges, and support needs.
Personal Details
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Preferred Contact Method
*
Phone
Email
SMS
Caring Role Information
What type of carer are you?
*
Parent carer
Foster carer
Kinship carer
Carer for partner
Carer for parent
Carer for child with disability
Carer for adult with disability
Mental health support carer
Aged care carer
Other
How long have you been in a caring role?
*
Less than 6 months
6–12 months
1–3 years
3–5 years
5+ years
On average, how many hours per week do you provide care?
*
0–10 hours
10–20 hours
20–40 hours
40+ hours
Full-time carer
Current Challenges
What do you struggle with the most at the moment? (Select all that apply)
Stress
Anxiety
Burnout
Feeling overwhelmed
Lack of time for self
Sleep issues
Managing behaviours
Emotional exhaustion
Financial stress
Relationship strain
Feeling unsupported
Navigating services (NDIS, Child Safety, Aged Care etc.)
Other
What would you most like help with from this group?
Register
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