Dalmellington: 01292 550696
Cumnock: 01290 426404
Kilmarnock: 01563 571533

Young Adult Carers

Hidden Carers Initiative

Respite Opportunities

Dalmellington House

Adult Carers Referral

Fill in the form below to start the process of registering as a carer or referring someone into our service.

Information on the Carer

Information on the Cared for individual

Was this form completed by the carer? (If yes, skip the next section and click "Submit". If no, please complete the Referrer section below.)

Information on the Referrer (if applicable)

Is the Carer aware of the referral?

What happens next?

Once we receive your submitted form, we will make contact to invite you along to our groups and to make use of our services. If this is being completed by a referrer, we may make contact with you for some further information.

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East Ayrshire Carers Centre Ltd is a charity registered in Scotland No SC024914
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