Carers Form

Please complete and submit this form. Our administrator Erika will update your records. She will send your details to Sheffield Carers Centre for you if you wish.

  • Carer details

    Date of birth
    For example, 15 3 1984
    Do you receive carers allowance?
    Do you wish to be registered as a carer at Handsworth Medical Practice?

  • Identifying carers

    We are interested in identifying carers, especially those who may be caring without help or support

    Do you provide care or support for someone who is ill, frail, disabled, or has a mental health problem?

  • Sheffield Carers Centre

    Sheffield Carers Centre is a dedicated organisation for supporting adults in Sheffield, who care for family or friends who could not manage without that support. They can add your name, address and phone number to their database, and you will receive a newsletter and other useful information about the service.

    Are you happy for us to share your details with Sheffield Carers Centre?
The information you provide on this form will be sent to our practice and used only to deal with your request. Depending on the form, this may include your contact details, personal information and health information. The practice may add it to your medical record and, where needed for your care, share it with other NHS and care services. To find out how we protect and use your information, please read our privacy policy on our website.
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Page last reviewed: 28 May 2025
Page created: 06 October 2026