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Carer with Support Needs

Assessment

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Carer's Assessment

How does this assessment work?

You can complete this form for yourself or on behalf of someone.

i.e. if you are a Carer, Relative or Friend.

How to Navigate

Click on the numbered sections on the left hand side of the window
or
use the Click on the numbered sections on the left hand side of the window or use the and options to move through the pages. DON'T use the Browser 'Back' button as you might lose information. image. and Click on the numbered sections on the left hand side of the window or use the and options to move through the pages. DON'T use the Browser 'Back' button as you might lose information. image. options to move through the pages.
DON'T use the Browser 'Back' button as you might lose information.

Protecting your information

When submitted, the data collected on this form will be treated confidentially and only used by Leicestershire County Council for the purpose of providing information, advice and support to meet your needs. To be able to do this, information may be shared with relevant NHS agencies and providers of carers' services to help reduce the number of times you are asked for the same information.
The information provided on this form will only be shared as allowed by current Data Protection Law.

The Form

Questions You DON'T need to answer every question, you need only complete what is relevant. image. Questions

You DON'T need to answer every question, you need only complete what is relevant.
Select the option(s) that best describe your situation. image. Select the option(s) that best describe your situation.
This symbol This symbol indicates that the question is mandatory and must be answered in order to continue. image. indicates that the question is mandatory and must be answered in order to continue.
A small blue question mark A small blue question mark after a question shows where there is further information. If you hover your mouse pointer over the question mark you will see the help text. image. after a question shows where there is further information. If you hover your mouse pointer over the question mark you will see the help text.
When entering a date, please use the calendar rather than typing the date into the box.
If you register or log in before completing your form, you will be logged out again after 15 minutes of inactivity - please make sure you save your form if you are called away from your computer.

Options

Save the Form

Use the Save the Form Use the option to Save the form to return to at any time in the next 30 days. image. option to Save the form to return to at any time in the next 30 days.

Print the Form

Use the Print the Form Use the option to Print a copy of the form if required. Once you have submitted a form you will no longer be able to see it, so it is a good idea to print off your form before submitting it. image. option to Print a copy of the form if required. Once you have submitted a form you will no longer be able to see it, so it is a good idea to print off your form before submitting it.

Having Difficulty Understanding the Assessment Process?

If someone speaks on your behalf, they are commonly known as an advocate.
Click here for information about advocacy.
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