Referral form: Mental Health Carer Support Service

*Referrals cannot be actioned without explicit consent from the carer

Carer Details

Cared for Details

Medical Condition - Cared for

Equality and Diversity

Crossroads Care Rotherham strives to operate a policy of equality and diversity and not discriminate against any person. The information you provide will be treated in the strictest confidence and is for monitoring purposes only.
DISABILITY DISCRIMINATION ACT 2005 A person has a disability under the Disability Discrimination Act if he/she has a physical or mental impairment which has a substantial and long term diverse effect on his/her ability to carry out normal day-to-day activities. Long term means has lasted, or is expected to last for 12 months.