Carer Registration

Hello! Thank for your registering with us. We need a bit of information about you and the person you care for. We will contact you shortly to complete your registration.

Sandwell Carer Registration Form

Carer Details

Fields marked with a * must be completed
Please enter date as DD/MM/YYYY
This information helps us to tailor services to give you a better 
You can select multiple options by holding Ctrl as you select

Information about your Caring Role

Please Enter Date as DD/MM/YYYY

Who you care for

Please enter date as DD/MM/YYYY
You can select multiple options by holding Ctrl as you select
Please enter date as DD/MM/YYYY
You can select multiple options by holding Ctrl as you select

Wellbeing Self Check

To help you reflect on the impact of your current caring role, you have the option to complete a Wellbeing Self Check. The answers you provide in your Wellbeing Self Check will allow us to tailor and provide you with support which may be useful to your current situation.

Your Carer ID Card

Our Carer Friendly ID and Card is the easiest way to verify you’re an unpaid Carer when you‘re out and about nationally. You can use either one in situations where you are required to identify yourself as a Carer, such as: 
When you are asked for prove you are a verified Carer.  
In healthcare settings to be included in the conversation around medical planning For the person you care for 
With an employer if you want to be recognised as a working Carers and request additional support due to your caring role 
On the reverse of your Carer ID Card we will record your emergency contact details, this is the person who should be contacted in the event something happens to you.
Your Carer ID Card also includes a photo of you which you will need to upload here. The picture needs to be a head and shoulders image that you are comfortable using on the front of the card. 

Support Required

Contact Information