Self Referrals


By joining Carers Centre you will receive free help, support, information and advice as well as access to breaks and activities. Carers can also get involved in helping to develop carers’ services for the future. Carers need to be caring for an adult who lives in Telford & Wrekin to access these services. Fill in the form below to join Carers Centre and we will get in touch.

Why join us?

To receive the full benefit of our support – if you are registered as a carer then we can provide you with the help you need such as:

  • Access to a support worker – there to listen, give support and practical advice
  • Signposting to a wide variety of other services
  • Access to our Carers Support Groups
  • Opportunities to be involved with developing carers services
  • Access to the Emergency Response Carer Service
  • Access to a Carers Assessment
  • A regular Carers newsletter
  • Social Events

Please make a referral

We provide free support to our carers.

If you are a carer and feel you need some extra help or just need someone to talk to, please get in touch with Linda, our Initial Assessment Officer or make a self referral by completing the form below.

Self Referral Form

Carers Name (required):

Carers Email:

Carers Telephone Number (required):

Carers Postcode (required):

Name of the person you care for? (required):

Age of the person you care for? (required):

Postcode of the person you care for? (if different to yours):

Any other information?

If you are referring on behalf of somebody else please fill in the following details:

Your Name:

Your Organisation:

Your Job Title:

Your Email:

Your Telephone Number:

Please enter the characters shown below:


You can download and complete our PC fillable form and email it to:

Carers Centre Referral Form PC Fillable

You may prefer to download, print and complete our carers referral  form:   

Carers Centre Referral Form

(To download the form, you will need Adobe reader. This can be obtained free of  charge by going to:

Please send completed forms to:

 Linda Boddison,
Initial Assessment Officer,
Carers Centre,
The Glebe Centre,
Glebe Street,
Telford TF1 1JP

 Telephone: 01952 262061