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

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. 
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