Making a referral

If you are a health professional, please read the information below about how to make a carer referral to Carers Hub.

Adult Carers Referrals

If you know of an adult carer aged 18 or over, first let the carer know you are making a referral and then complete as much information on the referral form below as possible. We will contact the carer to outline the support we can offer.

PLEASE NOTE : Because of the demand for our services it may take a number of days for us to get back to you and the carer

Alternatively you can call us on (01273) 977 000 to discuss making a referral.

Referrer Details

Your name (required)

Your job title (required)

Your email (required)

Your contact details (required)

Reason for referral (required)

Carer Details

Carer's name (required)

Carer's date of birth (required)

MaleFemaleOther

Carer's address including postcode (required)

Carer's email

Carer's landline number

Carer's mobile number

OK to leave a message
YesNo

Sensory or communication needs e.g. interpreting?

Other members of the carer’s household
(please list names, ages and relationship to carer)

Has the carer had a Carer’s Needs Assessment
YesNo

Is the carer on the Brighton & Hove Council Carers Register
YesNo

Is the carer aware of this referral and have they consented to us contacting them
YesNo

About the cared-for person

Cared for person's name (required)

Cared for person's date of birth (required)

Cared for person's gender
MaleFemale

Cared for person's address (if different from carer’s)

Relationship to carer (eg parent/partner/friend)

What is the cared-for person’s health condition and how does it affect them?

Cared for person's GP surgery

Are there any services or agencies involved?
(e.g. a care agency/Crossroads respite service)

How can we help?

Type of support

Are you aware of any issues related to safeguarding, impacting on the carer or cared-for person? If yes, please give details

Are you aware of any risks to workers/volunteers making home visits?
If yes, please give details

Any other information

Data Protection & Newsletter

In order to proceed with your referral, we will need to add your and the carer/cared for person's details to our database. We will only use your and their personal information to provide you with information and signpost you to other services that relate to your professional role. You and the carer/cared for person can change your mind at any time by contacting info@carershub.co.uk to remove your personal information from our database.
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