Young Adult Carers Referral


Name of Persons "Cared For"


Young Carers Contact Details


Nature of Illness/Disability

Other agencies involved with YAC and/or family:
GP practice to whom the young adult carer is registered.

Please note that if this section is completed yupr GP practice may be contacted toinform them of this referral. We would always encourage any young person to make their GP aware of their caring role.

Referral agents details

If you are self-referring you do not need to fill in this section:


Please include the reason for referral, including the impact and effect the caring role has on the young adult carer:


Young Adult Carers Referral Form

Sarah Kidd at
Tel: 01738 567076
Fax: 01738 440717

Definition of a Young Adult Carer:

Young Adult Carers are between the ages of 16 to 25 years and look after a friend or family member of any age due to disability, mental illness, chronic/terminal illness and/or problems relating to substance misuse.