Carers in Southampton accepts referrals for carers of adults and children but can only provide carers assessments for carers of adults over 18 with additional support needs (disabled/ill/elderly) who live in the local area served by Southampton City Council.  If there are young carers in the household please also make your referral to the Young Carers service. Before you refer, please note that we do NOT provide respite, professional carers, home visits, create or store emergency plans or provide crisis intervention.  If you are referring a carer to our service please click the link below, complete the form with the full consent of the carer, and return it to Carers in Southampton.  

You can type directly into this referral form

To complete this as a fillable PDF you may need to select an option to download in Acrobat, when prompted or if on an Apple device, select the option to Create PDF.

You can also print and fill this form by hand: Word version of referral form