Completion of this section is optional. This information will not be passed on to any other organisation.
By consenting you are agreeing that you have got permission from the person you care for.
Completion of this form means that you are registered with NEWCIS. Please ensure you complete the boxes if you wish to receive a regular copy of the quarterly newsletter, register with your GP as a carer, receive an information pack and/or receive further contact from NEWCIS. If you do not require further contact from ourselves at this time please do not hesitate to get in touch with us in the future if your caring role/circumstances change and you require support.