Visual Assessment for Young Carers for young carers aged 5-11 years old Visual Assessment - Primary School "*" indicates required fields Young Carers come in all shapes and sizes. They can be any young person between the ages of 5 – 17 who do lots to help a loved one with an illness, disability, mental health condition or dependent on drugs/alcohol. Barnet Young Carers is here to help you with the care you provide for your loved one by offering you someone to talk to; helping you keep up with school work; supporting your family and best of all - giving you a chance to have some fun with lots of activities. My Name Is* The Person I Care For Is* I would like a copy of my assessment* The email address will be used to email a PDF copy of this assessmentHelping around at home - please select the things you help do at home Helping with personal care - please select the things you help the person to do Helping with emotional support - please select the things you do to help the person if they are not having a good day Helping with practical support - please select the things you do to help the person Please tell us if there is someone who helps you with these things* How does caring for the person make you feel? Select the appropriate emoji* If you were granted a wish that would help you at home with your caring role, what would it be?* I live at home with:* My birthday is:* DD slash MM slash YYYY My favourite colour is:* My favourite movie is:* My favourite music is:* My favourite sport is:* My biggest talent is:* When I grow up I want to be:* If I had a super power for the day, I would like to be able to:* I am currently in year:* If I am worried about anything at school, the teacher I talk to is:* My favourite subject at school is:* The subject I might need some help with is:* The best thing about school is:* The most difficult thing about school is:* Are you ever late for school?* Never Sometimes A lot Do you ever miss school?* Never Sometimes A lot How I feel about school. Select the appropriate emoji* My favourite thing to do during the weekend is:* One activity I would like to try is:* My favourite game to play is:* If I could go on a day trip, I would like to go:*How often do you see friends outside of school?* I never see them I sometimes see them I see them a lot How I feel about my social life. Select the appropriate emoji* Are you part of any teams/clubs?* Yes No If yes, tell us what you do* Social activities and clubs (through Barnet Young Carers and local organisations)* Help in school (having someone to understand my caring role/school groups)* Outings* Help with school work (tuition; homework clubs)* Having someone to talk to about my caring role (a referral to be made to receive 1:1 mentoring/counselling)* Someone to train me with things that might make my caring role more manageable (e.g. cooking; life skills workshops)* Someone to help me look after the person I can for* Support online (Barnet Young Carers website/social media)* Is there anything else you would like support with? Let us knowEmailThis field is for validation purposes and should be left unchanged.