How you'd like to help

About you

Email(Required)

Which of these best describes you?(Required)

I think of myself as a carer

I support someone with dementia but don’t usually use the word carer

I used to care for someone with dementia

I don’t have direct caring experience but would like to support dementia carers

Something else

Prefer not to say

When you first thought about getting involved, what were you hoping to do?

Ways to take part

Which of these might feel manageable or interesting to you?(Required)

Select any that apply. You are not signing up to anything by answering.

How much time would usually feel manageable for one activity?(Required)

5 minutes

15 to 30 minutes

1 hour

A one-off session of up to 2 hours

A short project across a few weeks

Regular involvement over a longer period

It depends on the subject and what else is happening

I am not sure yet

Your experience and ideas

Caring can mean having to learn a great deal. Are there subjects you have experience of and might be willing to share?

Tell us what you have experience of

Is there something you would like Dementia Carers Count to understand, help change or offer differently?

This could be an experience, a gap you have noticed or a way you would like to contribute.

Keeping in touch

How would you like us to contact you about involvement opportunities?(Required)

Only when something is directly relevant to my interests

With a quarterly email update about ways to get involved

I don’t want you to contact me about opportunities to get involved

Please note, if you are subscribed to our monthly newsletter, ticking here won’t unsubscribe you

Please tell us how you would prefer us to contact you(Required)

Telephone

Email(Required)

We’ll only use this to send information you’ve asked for about ways to get involved, unless you’re already signed up to our newsletter.

Phone(Required)

Country Phone Number

Which region of the UK are you in?(Required)

This helps us share opportunities that may be relevant to where you live.

Thank you for taking the time to share your thoughts with us. When you submit this form, we’ll share opportunities with you if you’ve asked us to. There is no obligation to get involved. We’re grateful for your help.

About you

Ways to take part

Your experience and ideas

Keeping in touch

Keep in Touch!