YOUNG CARERS FEEDBACK FORM

All information given will be dealt with in strictest confidence.

If you would like us to send you any of the following information
Please complete the name and address section and check the boxes below that meet your requirements.

Your Name
Email address
Telephone number

Address, including postcode

More Information about Carers Together

Local Carers Support Group

Newsletter

Carers helpline

Young Carers Befriending Project

Would you like your name added to our mailing list?

Please state whether you are a: Carer / Carers Worker / Volunteer / Group / Young Carer / Other
Please write your comments in the box below.

Have you any special interest e.g. Parkinson's, M.S. Alzheimer's etc.
Please write in the box below.

Thank you for completing this form. The Wizards will be in touch with you to discuss any of the ideas you have put forward, and send any details you may have requested.