Are you a Carer? chat If you consider yourself to be an unpaid carer living in either Nottingham City or Nottinghamshire County and would like to access support please complete the following questionnaire to register yourself with Carers Hub Service: "*" indicates required fields I am aged between*Please selectUnder 2525-3435-4445-5455-6465 overDo you have a parent, spouse, sibling, family member or friend with a physical/learning disability, mental health condition, problems with drugs or alcohol, or a long-term health condition/illness? Yes No Do you help that person with every day household chores? Yes No Do you manage medication for the person you care for? Yes No Are you responsible for managing bills and finance? Yes No Do you often worry about the person who is unwell? Yes No Does the support you offer stop you from having time for yourself? Yes No Does your caring role impact on you being able to attend appointments? Yes No Are you currently in education, training or employment? Yes No Are you currently in education, training, employment or retired? Yes No Have you ever received a carers assessment through other carers support services or social care? Yes No Are you, or a family member, a veteran? Yes No Do you care for someone who is a veteran? Yes No Do you have a lasting power of Attorney for both health and finance? Yes No Would any of the follow support help you in your caring role? Carers assessment to identify level of caring role Access to groups Telephone support Face to face support Support around sign posting to other service including respite If you answered YES to any of the above questions and would like to access support from Carers Hub Service please complete details below and submit. First Name Last Name GenderSelectMaleFemaleOther or prefer not to sayEthnicity Mobile NumberEmail Please indicate the area in which you live: Nottingham City Rushcliffe Gedling Broxtowe Mansfield Kirkby in Ashfield Newark & Sherwood Worksop Bassetlaw Other Please add any other Information that you feel would be relevant , including any communication needs or health/mobility issues.How did you find out about us?*Please selectCarers Federation TrainingEducation organisationsHealth organisationOther organisationWord of mouthSearch engineSocial mediaTuvidGP practiceOtherConsent* I agree to the privacy policy.By submitting this form I agree to sharing my information with Carers Federation according to the Carers Federation privacy policy.CAPTCHA