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Get support if you're a young carer

Please use this form if you are a young person in Lincolnshire, Medway or Newham

We are unable to accept the referral if consent has not been given. If you are aged 13 or over you are able to consent yourself, if you are under 13 you will need to ask your parent or legal guardian to complete the parent / guardian referral form on our website

Complete form

Select your local service
Your details
Please indicate if home schooled or does not attend school
What level of care do you provide each week? Please include any emotional support as well as helping at home, preparing meals etc.
Do you have any needs of your own?
Please provide details including any named keyworkers and contact details
By family we mean anyone who lives with you or who helps with providing support. Please provide: a) name, b) relationship to you, c) indicate if they live with you.
How do you want to be contacted?
Times to avoid making contact
Parent guardian preferred contact method
What support are you interested in?
Or tell us anything else which may be useful in order to provide appropriate support
Please ensure the young carer consents to the referral.