Self-referral for Adult Social Care
Use this form to:
- refer yourself for help from Adult Social Care
To apply you'll need your:
- personal contact details
- GP's contact details
If you're not sure if you fall under Brighton & Hove City Council, you can check your local authority.
If you need help filling in this form, you can:
- send an email to firstname.lastname@example.org
- phone 01273 29 55 55
We process, analyse and use your data in a range of ways to better understand what our customers need and to improve the way in which the council delivers your services.
Find more information about how we use your data in our privacy and data notice.Start