Carer Registration - Carers Voice

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Please complete this form to register for the Carers Voice programme to share your views and experiences. Your feedback helps is shape and design our services to meet your needs and improve the lives of all Carers.

Carer Details

First Name

Last Name

Date of Birth

Your Postcode

Email

Phone Number

Please check this is correct before submission

Are you now, or have you ever provided care for someone? (Excluding employment as a carer)

YesI have, but no longer doNo

How long have you, or were you a carer?

Carer Situation

Carer Organisation

This is about the support you access and receive.

Are you registered with a carer service?

ID No / Reference number (if known)

Your Carer ID number can be found in the Carers Card letter/email sent to you from CRISP or Carer Support Dorset. If you can't find this, please contact them and ask for your ID number

Your Experience

This is where you can tell us a bit about yourself.

Do you have any specific areas of knowledge, interests, or passions relating to caring? Please share: (e.g. caring for someone with dementia, involvement in a support group, fundraising, or anything else)

Do you want to share anything else with us?

Please tick how you would like to be involved in Carers Voice

Completing Questionnaires/ SurveysIn Person Focus GroupsSharing your Caring Story

How did you hear about Carers Voice?

We want to ensure that every Carer has the opportunity to share their views and experiences. By sharing details about your gender, sexual orientation, and ethnicity, you help us: tailor support & events, ensure representation and improve our services. All information is kept confidential and is only used to help improve our engagement and support for Carers. The questions are based on the Census 2021.

What is your sex?

What is your ethnic group?

Which of the following best describes your sexual orientation?

Is the gender you identify with the same as your sex registered at birth?

YesNo

Do you have any physical or mental health conditions or illnesses lasting or expected to last 12 months or more?

YesNo

Please tick this box to say that you have read and understood the privacy statement

Yes, I have read and understood the privacy statement

Would you be interested in volunteering for us? Find out more here.

YesNoMaybe

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