Social care referral

If you have a patient or client who you think would benefit from our services please contact us.

If you have a referral, please use the form below or contact CarersLine on 0117 965 2200.

Once received, the carer will be contacted by phone within 14 days. If we are unable to make contact by phone, CarersLine will write to or email the carer. If the carer does not take up the offer of support, CarersLine will contact the referrer to let them know.

Security of the site

Please note that when you submit information using this form, it is not being emailed. Information is collected in a secure database through the website and the website’s host server is protected by firewalls. The only way to get access to this information is through designated Carers Support Centre staff. All access is by personal log ins and passwords.


  • Referrer's details

  • Carer's details

  • Dependent's details

  • This field is for validation purposes and should be left unchanged.