Important - We have been advised that the myGP App will cease in the near future. We recommend that patients using this App should switch to another service, such as the NHS App or Patient Access.

Riverside Surgery

525 New Chester Road, Rock Ferry, Wirral, CH42 2AG

Telephone: 0151 645 3464

riversidesurgery.birkenhead@nhs.net

We're open

Carer Information Form

DO YOU LOOK AFTER SOMEONE WHO IS ILL, FRAIL, DISABLED OR MENTALLY ILL? If so, you are a carer and we would like to support you. Please complete this form. If you agree, we will pass your details to the Carers Service, an organisation providing information and advice, local support services, newsletters and WIRED Carers Service for carers. We will also refer you, with your permission, to have your needs assessed by Adult Care Services. A carer’s assessment is a chance to talk about your needs as a carer and the possible ways help could be given. It can also look at the needs of the person you care for. This could be done separately, or together, depending on the situation. There is no charge for an assessment.

Your Details:

Your Name:(Required)
Date of Birth(Required)
Your Address:(Required)
Your Email Address:(Required)

Details of the person you look after:

Name:(Required)
Date of Birth:(Required)
Address:(Required)
Please pass my details to the Carers Service:
Please refer me to Adult Care Service for a Carer's Assessment:

Thank you for completing this form.