Young Carers Referral Form

Young Carers Referral Form

The information you enter below will be used to begin a referral procedure with the Young Carer's team at Carers Trust Crossroads Sir Gâr. Please answer all the questions as fully as possible in order for us to provide you with the best help. All information submitted here will be treated with confidentiality, and in accordance with GDPR and our Privacy Policy.
  • This section is for the Young Carer's personal information:

  • Black / African / Caribbean / Black British African Caribbean
  • The section below is for information of the person being cared for:

  • This section is for information on the care situation:

  • Extra details:

  • Date Format: DD slash MM slash YYYY
  • This field is for validation purposes and should be left unchanged.

Carmarthen Office

Suite 11, 2nd Floor West
Ty Myrddin, Old Station Rd
Carmarthen Office
SA31 1LP
01267 220046

Llanelli Office

The Palms Unit 3
96 Queen Victoria Road
Llanelli
SA15 2TH
01554 754957

Ceredigion Office

Plas Antaron
Antaron Avenue
Aberystwyth
SY23 1SF
07985 672131

Registered charity No. 1121666
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Crossroads Sir Gâr is a company limited by guarantee registered in England and Wales No. 6199277