Self-referral form

By completing this form I agree that Worcestershire Association of Carers may hold confidential information about me and can exchange this on a ‘need to know’ basis, with other agencies that may assist me, including, but not limited to: Voluntary Organisations, Health and Social Care Professionals.

This is a self referral form to make Worcestershire Association of Carers aware of the needs and support you may have in your caring role. Under the Care Act 2014 you are entitled to access Information, Advice and Guidance to enable you to continue caring.