Self-referral form


Request to register as a carer with Wigan and Leigh Carers Centre

To register as a carer with us, please ensure that the person you care for lives in the Wigan and Leigh Borough and pays their Council Tax to Wigan Council. If you need to find your local Carers Support Centre, visit Carers UK.

Registering with Wigan and Leigh Carers Centre as a carer means we can keep you up-to-date with the latest information and support for carers in nationally and locally in Wigan. We can also provide you with our Emergency Carers Card which identifies you as a carer and register you with your GP (if not already registered). You will receive an information pack, our monthly Carers Newsletter and invites to regular events and social activities for carers. We can also offer emotional and practical support, including counselling, and access to our volunteers team who can assist with complex benefit forms or befriending.

Please complete all the fields below and then click on the SEND button at the end.

If you prefer one of our friendly staff to call you and complete the questions over the phone, please call us on 01942 705959.

Adult Carer Information

Name(required)
DD slash MM slash YYYY

Information about the person you care for

DD slash MM slash YYYY
Agreement(required)
Agreement

What happens when you receive my form?

When we receive your completed form, a member from our Carer Triage Team will call you to talk to you about your caring situation and tell you about the services available to you. At the end of the discussion we will agree the things that we will do to support you. You can ask for a review at any time as we know that many carers’ situations can change suddenly.