Register with Carers MK

Are you looking after someone who cannot manage without you because they are ill, frail or disabled? If so, you are a carer and Carers MK is here for you.

Complete our registration form below to register with Carers MK and make use of our free services, including information, advice, guidance, emotional support and a listening ear. Once we have received your form we will be in touch to complete your registration and to explore how we might be able to support you in your caring role. 

For information on how Carers MK stores and uses your personal data, please see our Privacy Notice.

If you would prefer to register with Carers MK manually, please feel free to contact us on 01908 231703 or mail@carersmiltonkeynes.org

    First name (required)

    Last name (required)

    Your date of birth (required)

    Are you aged 18+? (required)
    Yes
    If you are aged 17 or below, please fill in our Young Carers referral form.

    House name/no (required)

    Street (required)

    Postcode (required)

    Your email address (required)

    Your phone number (required)

    Who do you care for?

    Is the person(s) you care for under 25 years old?
    YesNo

    What is their illness/disability?
    ElderlyDementiaMental IllnessPhysical DisabilityLearning DisabilityOther

    Parent Carers – if you are caring for a child or young person up to the age of 25 who has an illness, disability or special educational need, we would also like to refer you to a partner organisation PACA MK (Parent And Carers Alliance MK), for additional information and support.
    Please tick if you would NOT like us to pass on your details securely to PACA MK
    No

    Further information request

    Are you or the person you care for currently in hospital?
    YesNo

    How did you hear about our service?