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Adult Social Care Online Referrals

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This online referral form enables members of the public and professionals to make referrals to Cumbria County Council's Adult Social Care service to request an assessment of social care need.  This new online form was introduced in 2010 to replace an old one.  If you used the old form, you will see some important differences.  The new form is quicker and easier to complete and we hope it will encourage more people to make referrals online.

Please ensure you read these details before completing the form: 

  1. If you wish to refer someone you know, you must do this with their consent.      
  2. We will deal with new online referrals within the next working day.  Please do not use the online referrals for urgent or emergency enquiries.  You should telephone these through to Customer Services at your local Adult Social Care office.  
  3. If you have an emergency outside of office hours, at weekends or bank holidays, please contact our Out of Hours Service on 01228 526690. Our offices are open: Monday to Thursday 9.00am to 5.00pm, Friday 9.00am to 4.30pm.  
  4. You will need to complete the form within 30 minutes in order to avoid your session timing out and you losing your data.  You can copy and paste text across from another source, however. 
  5. Please use an up to date Internet browser (Explorer, Firefox, Opera, etc.), i.e. latest 2 versions, to ensure full functionality of the form.

To use the Adult Social Care online referral form, please use this button:




Professional agencies wishing to make a referral to Adult Social Care on paper can download our form below.  Guidance notes on how to use the form are also available.

If you have any comments about the new Adult Social Care Online Referral Form or encounter any difficulties using it, please use the feedback form to get in touch.  We will aim to get back to you within 10 working days.