Manor Street Surgery

Manor Street, Berkhamsted, HP4 2DL

Current time is 17:28 - We're open

Telephone: 01442875935

Fax: 01442 875936

Out of Hours: 111

Latest News (click title to open):

COVID Vaccination Appointments

Young Carers Support

COVID Vaccination Scam – Please be aware

You are here:
Home
/
Register as a Carer

You are here:
Home
/
Register as a Carer

Register as a Carer

Please note: We have had a massive influx of people registering as a Carer in the last few days, please be aware that registering as a carer will not make you eligble to receive a COVID vaccine unless:
- You are eligble to receive a carers allowance, this means:
  - You're over 16
  - You spend at least 35 hours a week caring for someone
  - Your earnings are £128 or less a week after tax, national insurance and expenses
  - You're not in full time education
- You are the sole or primary carer of an elderly or disabled person who is at increased risk of COVID-19 mortality and therefore classified as clinically vulnerable
Ensuring our carers are identified, supported and stay well is essential so if you are are carer for someone, please complete the form below.

We work alongside Carers in Herts to ensure all carers receive the most support possible, by completing the below form you are consenting for us to register your details not only with The Manor Street Surgery, but also to refer you to Carers in Herts so you receive their support as well.

For more information on Carers in Herts please click HERE.
Your Details
Title First Name Last name
Date of Birth

DD
MM
YYYY
Email Address
Home Address
Street Address Address Line 2 City Post Code
Telephone Number
Do you receive carers allowance?
If you choose yes proof may be requested.
Do you spend at least 35 hours a week caring for this person?
Details of person being cared for
Name
First name Last name
Date of Birth
Date Format: DD slash MM slash YYYY
Address
Street Address Address Line 2 City Post Code
What relation to you is the person being cared for?
Is the person you care for a patient at this surgery?
Phone
This field is for validation purposes and should be left unchanged.