Mental Health Support Fund Application Form

Applicant Information

Application on behalf of Eligible Care Worker

Employment Information


Information gathered in this section will not affect your application.  It is taken for demographic reporting only.  It is not accessible to the assessors considering applications.

If you’re not sure how to answer, use the sex registered on your official documents, such as passport or driving licence, or whichever answer best describes your sex.

This information is used to monitor equality between groups of people of different sexes. Equality monitoring helps make sure that everyone is treated fairly.
Support Request

The mental health support programme will be offering applicants who meet the criteria a series of support sessions with a therapist. 

Please note this is not a financial grant, The CWC will pay the service provider Red Umbrella directly for your sessions. Once accepted onto the support programme you would be contacted by Red Umbrella who will set up the sessions with you. 

Please note: We are not offering money towards Mental Health Support - we are working with a provider of these services and would be offering people who meet the criteria a series of support sessions with a therapist. 

Permission to Share Contact Details with Provider


Who referred you to the Fund? (please select no more than 3 options)