Young Carers - Professional Support Requests (External)

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Activity 2

Privacy Notice

Please confirm the following:
I have obtained express consent from the parent/guardian of the young carer(s) being referred to provide all of the information required and request support from Carers Resource. Before you proceed, we would like to draw your attention to our Privacy Notice. Your privacy and data protection are of utmost importance to us, and we want to ensure that you are fully informed about how we collect, use and protect your personal information. Please take a moment to review our privacy notice. Privacy Policy

Initial Information

How many young carers do you wish to refer?
How many indviduals does the young carer(s) support?
Professional

Professional Referrers Details

Phone Type
Phone 2 Type
Professionals Employer

Referring Organisation

Type of Organisation
Young Carers Details

Young Carers Details

Further Demographics
Is the young carers disability substantial and/or long term?
Young Carer 1 West Yorkshire Schools

West Yorkshire Schools

Young Carer 1 North Yorkshire Schools

North Yorkshire Schools

Young Carers Details 2

Young Carers Details

Further Demographics
Is the young carers disability substantial and/or long term?
Young Carer 2 West Yorkshire Schools

West Yorkshire Schools

Young Carer 2 North Yorkshire Schools

North Yorkshire Schools

Cared For 1

Cared For Individual

Relationship to the first young carer
Relationship to the second young carer
Conditions
Condition(s)
Please select all that apply
Cared For 2

Cared For Individual

Relationship to the first young carer
Relationship to the second young carer
Conditions
Condition
Parent / Legal Guardian
Activity

Details of Referral

Does the young carer have a parent within the military?
Activity 3

Details of Referral

Does the young carer have a parent within the military?
Assign To
Referral Fields