Please use this form to register a young carer who lives in the Devon County Council area. The person they support maybe ill, frail, disabled, have a mental health issue or substance misuse problem.


If you need this form in another format or support to complete it please contact us via email or via telephone 03456 434 435

Consent Information

Referral Information

Reason for Registration

About the person the young carer provides care to

The conditions listed below are definitions taken from the Office for National Statistics website. Please select the option that most accurately describes the main condition of the person you/the young carer primarily cares for.

MH = Mental Health
Dev = Development
Neu = Neurological
Phy = Physical
Sen = Sensory

Young carer details and contact information

GP Surgery

Please select GP Practice from the list below. If you can’t find the surgery use the ‘GP Surgery – Unknown’ option. If you/the young carer live out of the Devon County Council area and the GP Practice is not on the list, please select ‘GP Surgery – Out of County’


Please select school from the list below. If you can’t find the school select ‘School – Unknown’. If you/the young carer’s school is out of the Devon County Council area and the school is not on the list, please select ‘Out of County - School’. If not in education, select NEET.

Other Information

Equality and Diversity Monitoring

These questions will help us check that we have reached a representative section of society and help us to identify inequalities. Those who are in the minority groups may experience isolation, ‘invisibility’ and exclusion and this is particularly true of carers. It is therefore important we take notice of their experience and needs.

You do not have to provide this information, or you may choose to provide only some. Any information you do provide will help us to plan services for all carers.

Thank you for referring this young carer to Devon Carers. See for more information on how to get in touch should you need to.