You are a Carer if you provide support to someone who cannot manage without you because they are ill, frail, disabled, have a substance misuse problem or mental health condition. The care you provide may be practical, emotional or supervisory.

    If you are a Carer, and you want your GP to know, please complete the form below.
    As a Carer you may also be eligible to receive a Covid-19 vaccination sooner than you would otherwise.

    After completing this form, if you are not already registered with us, we will get in touch with you as you must be registered for us to share your details with the organisations you are asking us to share them with.

    By completing this form, you agree to the Carers’ Support Service storing your information confidentially on an electronic database.


    We will share your details with your GP practice


    If you are aged 18+ and care for someone aged 18+ your details will be shared with Focus Independent Adult Social Care. If you are a Young Carer or Parent Carer your details will be shared with North East Lincolnshire Council

    Please complete all fields below

    Your Details:








    Please select your GP practice from the drop down list:

    Please select which best describes you:

    Details of the person you care for:







    Please select the GP practice of the person you care for from the drop down list:

    If you are not registered with the Carers’ Support Service, you will receive a call from a member of the team to talk to you about your caring role. Registering with the Carers’ Support Service is completely free and you can choose whether or not you access the support available to you.