Adult Carers: GP Referral

GP Referral Form

"*" indicates required fields

Barnet Carers Referral Process

All referrals are sent to our Carers Services Team. We aim to follow-up the referral within 3 working days. At busy times, these planned times may be extended.

Importance in acquiring Carer's Consent
It is important to receive the consent of the named carer. We require the confirmation that the consent of the carer has been given as part of this referral in order to proceed in making contact on completed submission.

GP Name*

Prefix First Last

Associated Surgery*

Email Address*

Would you like us to provide feedback to you on process / progress?*

Yes

Only in the case of complications

Carer's Name*

First Last

Carer's Primary Contact Number*

Carer's Email Address

Please enter the postcode below and click on the Lookup Postcode button

Carer's Address*

City*

Postcode*

Carer's Date of Birth*

Does the carer have a medical condition that may impact their caring role?*

Yes

Carer's Disability/Medical Condition*

How does their disability/medical condition impact their caring role

Do you know if there is a young person (under 18) with a caring role?*

Yes

Unsure

Name of Person Being Cared For*

First Last

Person Being Cared For's Date of Birth

Relationship to Person Being Cared For*

Main condition of the Person Being Cared For

If Other, please give details

What support would the carer benefit from?*

Your contact

Adult Carers

Please use our electronic referral form where possible. If you do not wish to make a full referral but would like to simply register a carer or get other information, please feel free to email the Adult Carers team direct.

Email Adult Carers

Resources you might find useful

This section is under construction. We are currently creating a directory of resources that will be useful to you in your role. If there is anything specific that you would find useful, please email Kirsty.

Finance & Benefits

Carers Allowance
Benefits Calculator
Local Support

Carers Support

Leisure Pass Applications
Carers Star support
Activities

In need of care

Guide to choosing homecare
Respite care
Care homes

Other organisations

Barnet Mencap
Mind in Barnet and Enfield
Dementia Club UK