Refer a Carer

Please read this before completing the referral form.

We provide carer assessments, carer cards, social events, emergency plans, information and signposting to unpaid and family carers providing care to adults who are disabled, ill or elderly.

All carers can access free information and signposting but carer assessments are only for adults providing care to adult residents of Southampton City Council. Carer assessment outcomes include telephone information support and signposting. For those providing significantly high levels of care there may also be a small personal allowance (not means tested).

We do not provide respite, carers, home visits, legal or benefits advice or provide crisis intervention.

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Details of the carer you are referring

If the carer does NOT live with the person they care for, then please provide the postcode for person below

Details of you, the person making the referral
Consent to share. Has the carer given permission to share their details with us? Consent to share box below must be ticked.
That’s it. All done. Thank you for taking the time to fill this out.

If you choose to print off this form rather than submit it via our website, please send the completed form via email to [email protected] or print and post it to our address: Carers in Southampton, Meon House, Rear of 189 Portswood Road, Southampton SO17 2NF. If you have any questions about this form please email us or phone 023 8058 2387.