Referral Form

    Be Free YC provides respite opportunities to young carers, to allow them to have a break from their caring responsibilities and make new friends who understand their situation. When respite alone is not enough, additional services can be available at the charity’s discretion. This includes emotional support and befriending once support workers have assessed the need.

    Young Carer

    Parent/Guardian contacts

    Young Carers with additional needs can be referred, however Be Free does not have the capacity or training to provide one to one support on trips or activities. If a young carer has difficulties following instructions, regulating emotions, or engaging with others, it may not be appropriate for them to attend trips and activities for their own safety and/or the safety of others around them.

    We encourage you to contact support workers prior to referring a young carer with additional needs to discuss if we are able to support them.

    Person Cared For

    Assessment of Caring Role and Impact on Young Carer

    Please complete this with input from the young carer and their parents.

    How many days a week does the young carer do the following?

    How many days a week does the young carer experience the following due to their caring role:

    Contact details of person making this referral