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St Catherine's Surgery

First + Second Floor, Wing 4, St Catherine's Health Centre, Church Road, Birkenhead, Wirral, CH42 0LQ

Telephone: 0151 643 6700

cmicb-wi.stcatherinessurgery@nhs.net

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Register a Carer

A carer is anyone, including children and adults who looks after a family member, partner or friend who needs help because of their illness, frailty, disability, a mental health problem or an addiction and cannot cope without their support. The care they give is unpaid

It is important that we know if you are a carer so that we can make sure you receive information, services and the help that is available. If you are a carer please complete this form.

As a registered as a carer at the practice you are entitled to :

An annual flu vaccination
An annual health check
Longer appointments as needed
Appointments convenient to your caring responsibilities

For more information regarding support for carers please visit our Carers Page.

Register a Carer

Comments

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Carer Details

Name(Required)

First Last

Date of Birth(Required)

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City County / State / Region Postcode Country

Details of Person Being Cared For

Name(Required)

First Last

Date of Birth

Address including postcode:

What relation to you is the person being cared for?

Is the person you care for a patient at this surgery?(Required)

Yes