Register as a carer

Use this service to register as a carer so that we can make sure you get information, services and the help that is available.

You can use this service if you:

  • are registered at the surgery
  • are a carer

Before you start

We’ll ask you for:

  • your first and last name, date of birth, sex, postcode, email and phone number
  • if applicable, the details of the person you are completing the form on behalf of

You can also phone us on 0115 883 2330 or visit the surgery in person.

Name
Date of birth
Gender
As recorded on your medical record
Address
The one used to register with your GP
Email address
Anyone else with access to your email account may see responses sent to you

Details of Person Being Cared For

Name
Date of birth
Address
Address
Is the person you care for a patient at this surgery?