Witley Surgery

01428 682218

Milford Crossroads Surgery

01483 414461


Are you looking after or providing support for a relative friend or neighbour? Are you being helped or supported by a relative friend or neighbour?

Your GP needs to know so you can be offered the right information, support and access to services. GP surgeries have to compile information for the government about the numbers of carers attached to the surgery so your information will help them to do this.

Please complete the form below and return it to the surgery as soon as possible.

  • Carer details

  • Date Format: MM slash DD slash YYYY
  • Details of Person Being Cared For

  • Date Format: MM slash DD slash YYYY

There is more information about help with day-to-day living because of illness or disability on the NHS website.


Are you having difficulty with being a carer? Please let us know :

Carer Strain Index

  • A carer is someone who, without payment, provides help and support to a friend, neighbour or relative who could not manage otherwise because of frailty, illness or disability. Caring for somebody is never an easy task. Below are some statements that outline some of the difficulties which carers may face. You are unlikely to experience all of these, but I would like to know how much of a burden different aspects of looking after your relative are.

    Please rate your answers from 'No burden at all' to 'A great burden' below:

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