This self assessment helps you identify the areas where you might be eligible for social care and support.

At the end of this form you have the option of making a referral and requesting a formal assessment.

You can complete the form for yourself, or on behalf of someone else.

What you will need

Before you begin you will need the following:

  • A valid email address if you wish to be sent a copy of your self assessment
  • If you are completing this form on behalf of someone else you will need to know their personal details, for example their address and contact number

Start the adult social care self assessment

If you do not understand a question or are concerned that the form does not address your needs please call 01752 668000.

Please answer all questions honestly.

Finally, you or the person that may need social care support must live in Plymouth. If you do not live in Plymouth please contact your local council which is likely to be either Devon County Council, Cornwall County Council, South Hams District Council or West Devon Borough Council.