TEST FORM - Adults social care - copy

This is a test form - if you wish to refer someone for Adult Social Care please use this form: Social Care for Adults Online referral

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.

Before you complete this form, make sure you have all your information to hand. The system will time out after 30 minutes.