Self referral

If you are a young carer (aged 6-17) and would like to refer yourself for our services please complete our self referral form below:

Self referral form for young carers

If you experience any difficulties using our pdf form above you may prefer to use our referral form in Microsoft Word format. Please complete as much detail as you can and return by email to

Alternatively please ring the Young Carers Senior Support Worker on (01273) 746222 to discuss making a referral.

If you are a professional and wish to refer a young carer, aged 6 – 17please click here to complete our young carers referral form.

© The Carers Centre for Brighton & Hove Ltd. Registered Charity No. 1015728, Registered Company No. 2758481.