Referring people to Action for Carers

Referring people to Action for Carers

Professionals may wish to refer their clients directly to Action for Carers Surrey. The forms are below.

Please note, health care professionals in Surrey are encouraged to use the Carer's Prescription (see below).

Referral form

You may wish to refer a patient or client to Action for Carers Surrey.

Links to referral forms for adult carers and young carers are below.

Please note, if you are a health care professional, working in Surrey, you should use the Carer’s Prescription, but for direct referral, you can also use the forms below.

And we are more than happy for carers to refer themselves. Adult carers can do that through our register with Action for Carers form. Young carers, and their parents/guardians should give us a ring on 01483 568269 or email [email protected], but parents/guardians can also use the form given below.

To refer an adult carer

Please use this form:
NB this referral covers all of Action for Carers’ support for adults, including referral to our Moving and Handling service, and to our Young Adult Carers service for people aged 18-24.

Referral form for an adult carer

NB We also have Guidance on referring a young adult carers (aged 18-24).

To refer a young carer (under 18)

See our Guidance on referring a young person (under 18) to the SYC service

To refer, please use this form
(NB the Word version will not open on some i-phones, but will on all desktops):

Referral form for young carers (under 18) word document

Referral form for young carers (under 18) PDF


To refer to Moving and Handling services

Please use our (Action for Carers) standard referral form, which includes a section on Moving and Handling needs.

Refer an adult carer to Action for Carers Surrey

Please use this form to refer an adult carer to our services.

Referral form
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