Make a referral to The Carers' Centre

If you are a professional that has identified a young person with caring responsibilities, and would like them to benefit from our free services simply fill in this short form.

We will email you when we have received their details and will be in touch within the next few days.

If you would like to discuss the young person further or if you have any questions, please call us on 0800 0388 885 or email us at support@banescarerscentre.org.uk (Mon – Fri, 9am – 1pm).

For more information on how we look after carer data, visit our Privacy Policy.

About the young person
For example: 20/01/1970
Do they have any additional needs of their own? *
About the parent or guardian
Are they aware of this referral? *
About the young person's caring role
Are they on a child protection plan? *
Who do they care for? * Please select all that apply
Primary condition of their parent *
Do they look after more than one sibling? *
Primary condition of their sibling *
Primary condition of their second sibling *
Primary condition of their grandparent *
Primary condition of their friend *
Primary condition of this person *
Is there another person living in the house who is also providing care? *
What kind of support does the child provide? *
Are they being significantly impacted by caring? * Please select the areas of their life that are being significantly impacted
Has this child expressed that they are unhappy with their caring role? *
Please provide any further information about their caring role here. It is useful for us to know as much as possible before contacting the parent or guardian.
About you (professional referring)