Manchester Carers Centre

NEW CARERS REGISTRATION FORM

Manchester Carers Centre provides support to unpaid Carers living in Manchester. We offer a range of emotional and practical support services. If you are a Carer and and need support then fill in this form below and we will contact you.

We need your consent to store your information below on our database and to share your details with any necessary professional relevant to your enquiries. You can contact us at any point to withdraw this information. You can view our privacy policy on our website for more information.

    What is your preferred method of contact? TelephoneEmailLetter
    Do you work? Part-TimeFull-TimeNoRetired
    Would you like Information or Assistance with the following? (please tick all that apply)
    Carers AssessmentCarers Trust GrantsTelephone/Email AdviceHealth & Wellbeing Support GroupsInformation on ServicesShort Breaks & Social EventsMembershipTrainingOne To One AppointmentYoung Adult Carers

    Cared For Details

    If you are happy to do so, please provide details of your Cared For below, to help us identify the best kind of support for both you as a Carer and the person you provide care for.

    Please make sure the person you care for has given consent for you to provide their details below.

    Cared For Address
    Do you Care for More Than 1 person? YesNo

    2nd Person Cared For Details

    If you are happy to do so, please provide details of your Cared For below, to help us identify the best kind of support for both you as a Carer and the person you provide care for.

    Please make sure the person you care for has given consent for you to provide their details below.

    Cared For Address