Carers self-assessment form

This online self-assessment is used to gather information about an informal carer supporting someone living within West Berkshire who may need support with some or all their daily living activities (such as getting washed and dressed or accessing their local community).

If you need to get in contact with Adult Social Care in an emergency please find our contact information here.

According to NHS England (NHS - Who is considered a Carer) A carer has been defined as “anyone, including children and adults, who looks after a family member, partner or friend who needs help because of their illness frailty, disability, a mental health problem or an addiction and cannot cope without their support. The care they give is unpaid”.

You can use this form to let us know you need help with caring for another person.

The assessment can be completed by the person providing informal/family care or by someone else on their behalf where appropriate (e.g., a relative, advocate, or other professional).

This form only applies to adult carers . Carers aged 18 or below please contact Children or Family Services.

Once the assessment has been completed a member of staff will contact you for any additional information and to discuss outcomes and whether the eligibility criteria is met.

Privacy Notice and Confidentiality
In Adult and Community Services we share information when necessary to make sure we offer you the best support. To find out more please take a look at our Privacy Notice.

If you go on to submit a referral at the end of this form you will be asked if there is anyone that you do not wish to share this information with.

This form is 8 sections long and will take approximately between 40 and 60 minutes to complete.

You can save the form at anytime and finish it at a later date if needed.