Professionals Referral Form for Carers Assessment  

This form is for professionals to refer an individual for a carers assessment. This also gives access to the Universal Carers Service, which meets many carers’ needs.

We operate waiting lists so please read our guidance on referral for assessment.

You must have the individual’s consent to pass their information onto us. We’ll process and record the personal data you supply on this form in accordance with our privacy notice

If you need any help completing this form please contact or call 0114 278 8942. 

    SECTION 1: These first set of questions are about the carer you are referring to us and their caring role.

    SECTION 2: These questions are about the person being cared for.

    SECTION 3: The next set of questions are about you as the referring professional.

    Updated 16 June 2022