This form has 7 pages
When you make a request for social care services to Manchester City Council we call it a "referral". Please note that online referrals will not be treated as emergencies.
If you have an emergency please ring the contact service for social care on 0161 234 5001.
You are agreeing that any information contained in this referral can be shared with other appropriate council officers in accordance with the Data Protection Act.
About this form:
When you go through the form, don't use your normal 'Back' button to return to an earlier question; use the 'Previous' button at the bottom of the page you are on.
Questions marked * can't be left blank.
You have 20 minutes to complete each page of the form.