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Young Carer Referral Form

To access our support, the young person needs to meet the following criteria:

  • Aged 5 to 17 years old,
  • Caring or helping to care for a family member(s),
  • Caring responsibilities clearly show a negative impact,
  • Live in Swindon.

*Please ensure you have read the above criteria before referring, and ensure the young person has agreed to the referral*  


Please either complete the online form below or click here for a downloadable version. Please include all contact details and the young carer assessment, and return the completed from to info@swindoncarers.org.ukIncomplete referral forms will not be accepted.


Swindon Carers Centre are contracted by Swindon Borough Council to offer support services to carers in Swindon as part of Swindon Borough Council’s responsibilities under the Care Act 2014 and the Children and Families act 2014. In order to provide you with relevant services, it is necessary for us to collect certain information about the Young Carer and the dependent. Certain information will be shared with Swindon Borough Council to assess the services that carers in Swindon are receiving.