If you experience any issues using this form, please contact the Centre on 01786 447003 and let us know so that we can make improvements.

    Who are you referring?

    Are you making a referral for:
    Before making a referral to the Young Carers Service, please ensure you have read our service criteria.

    Young Carer Declaration of Consent

    In order to make the referral to Stirling Carers Centre, you must have consent to share the young person’s information with us, and we must have consent to contact them. If the carer is aged 16 or under then consent must be given by the parent/guardian.
    The above consents must be confirmed in order to submit this form.

    Adult Carer Declaration of Consent

    In order to make the referral to Stirling Carers Centre, you must have consent to share the person’s information with us, and we must have consent to contact them.



    If the carer is aged 16 or under then consent must be given by the parent/guardian. If this is the case please go back and select Young Carer on the previous page.

    The above consents must be confirmed in order to submit this form.

    Carer's Details

    Please ensure you have completed all fields marked '*' before continuing to the next page.

    Young Carer's Parent/Guardian Details

    Please provide parent/guardian contact details. At least one contact number must be provided for us to be able to progress the referral.
    Please ensure you have completed all fields marked '*' before continuing to the next page.
    This page contains information only required for Young Carers. Please click Next to continue.

    Role as a Carer

    Please ensure you have completed all fields marked '*' before continuing to the next page.

    Referral Details

    Please read over our service criteria before completing this section.
    Please ensure you have completed all fields marked '*' before continuing to the next page.
    This page contains information only required for Young Carers. Please click Next to continue.

    Your Details

    Legal information

    All information provided will be stored on our secure database and kept in accordance with data protection legislation. We will never share information with third parties without the consent of the carer or unless we are required to do so by law.