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.

You have the option of applying for a free Carer ID Card when registering with us. Have the name and phone number of your emergency contact number (next of kin), plus a head and shoulders photo of yourself to hand when completing this form.

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

The Carer Friendly ID Card allows Carers to self-identify as a Carer. This can be to professionals such as GPs when supporting the person they care for or to get offers at specific organisations/ locations. It can also be used to help in an emergency reach nominated persons who can take care of 

As part of the Carer ID Card, you will need to provide some additional information.
This includes:
  • Information about who you are caring for, 
  • Two people you can name as emergency contacts 
  • A photo of yourself to use to identify your card. 
Please have all of this information to hand before completing this section. You can apply for a Carers Card at a later time

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. 
The Peace of Mind Plan is a simple way to record key information about your caring role, in case you are unexpectedly unable to provide care due to illness or an emergency. It helps ensure the right people have the right information at the right time, reducing stress and uncertainty.

If you choose to include a Peace of Mind Plan, it will be securely linked to your Carer Friendly ID Card using a digital link. When scanned, this allows authorised services to quickly understand your caring situation without you needing to explain everything in a crisis.

Important:
If you have requested to include a Peace of Mind Plan with your Carer Friendly ID Card, you will need to complete this form in full so we can finalise your card. Any delay in completing this form will delay your card being processed and issued.





Support Required

Contact Information