Carer’s self-referral form

NOTE: This form is NOT for professionals. If you are a professional referring a Carer who you work with, please go to our professional referral form

We can only support you if you, or the person you look after, lives in the London Borough of Merton. If you live outside Merton, please contact us for information about support in your area.

If you can complete the form below, it will help us to reply to you quickly. However, if you are struggling with the form, please call us:
Telephone 020 8646 7515 (Mon-Fri 10am to 4pm).

Once you submit the form, we will be in touch to discuss your situation with you.