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Testing registration forms

This page is being used for test purposes only

​​If you are not already registered with us, click to complete the registration form to register as a: 

If you are a Professional and identify Carers during the course of your work, please gain permission for a referral, then visit the Professionals page.

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​Already registered?  You don't need to complete another form, just get in touch.

Adult Carers

Please complete this form if you are 18+ and live, work or care for someone who lives in the LB Sutton.

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If you are unable to complete this form for any reason, or would like to speak to someone in the first instance, please call us or drop-in to register during our office opening times.

Adult Carer Registration Form

​​Important notes:

  • Some 'required' questions are clearly marked with an asterisk (*), but necessary questions will be highlighted upon submission so you can complete them and re-submit your form.

  • Ensure ALL contact details and GDPR consents are completed accurately as we will get in touch to complete your registration.

  • When inputting dates, use the arrows or click the month/year to scroll multiple options.

About you

To complete your registration we need to speak to you. If you are unable to give permission for a phone call, please do not complete this form: either call us or drop into the centre and speak to a member of the team.

Can we call you?
Date of birth
Gender

Monitoring data

As a small independent charity, it is really useful for us to gain the following information for monitoring and funding purposes.  Any information will only be used anonymously unless we gain your express authorisation for any other reason.  Please help us by completing the following questions:

Marital status
Employment status
What is your housing situation?
What is your sexual orientation?
If you have health issues yourself, what does your main condition relate to?
Please select you ethnicity:
Please select your religion:

About your caring role

Do you care for more than one person?
Who is the main person you care for?

If you care for more than one person, we will gain more details when we speak to you.

About the person you care for:

Date of birth
What is their gender?
What is their main health condition?

Impact of caring

Tell us how you are doing at this time and about any immediate need for support.

Do you feel your caring role is:
Do you feel you are:
How well supported do you feel by those around you:
Do you feel your caring situation places you at risk or harm? e.g. through manual lifting, or if the person you care for can become aggressive.
Are you interested in any of the following services? Select all that apply:

GDPR

This section allows you to tell us how we may use your information.  We will not share any information without your consent in advance.

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We can only process your registration form if you provide permission to store your information AND contact you, sop please select which options you are happy with. Please note that our monthly Newsletter will only be received if a valid email address is provided.

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If you are concerned about the registration process, you are welcome to contact us on 020 8296 5611 to discuss how we may be able to help.

Do we have your consent to store your information?
Consent to share sensitive/personal data with Funders or Partners for monitoring purposes
Other than a phone call, which contact methods are you happy for us to use? Please select all that apply:
Adult Cares registration form
YC self registration form

Young Carers Registration

About Young Carer

Who is completing this form?
Date of birth
Gender
Do you have a health issues yourself?
How did you hear about Sutton Carers Centre?