Sign up to receive Alzheimer’s Society Companionship

Our Companionship Service connects individuals affected by dementia with trained volunteers through regular phone calls, weekly online groups, and access to a 24/7 online forum. These options provide a safe and welcoming space to chat, share, or connect whenever you need it. 

 

You can sign up for yourself or on behalf of someone else. Our Companionship team will reach out to discuss which options are best suited for your needs. All information is held securely. To find out more about how we use your personal information, please read our personal information policy. 

 

This form is intended for those seeking companionship support. If you’re are interested in volunteering, please visit our Companion Call Volunteer webpage. 

 

To receive support, you must meet the following criteria:

 

- Be a person living with dementia or awaiting a diagnosis

- Be a caregiver for someone with dementia

- Be able to answer a telephone

- Have internet access if you wish to join weekly online groups or use the forum

- Live in England, Wales, or Northern Ireland

 

If you would like a referral to be made on your behalf by a Dementia Adviser, please call our support line on 0333 150 3456 and ask to be referred to the Companionship Service. 

Would you like to sign up for yourself or someone else? (optional)

Would you like to sign up for yourself or someone else? (optional)

Your contact details (optional)

To sign up to Companion Calls for yourself, please enter your own contact details below.

 

We request your email address and phone number to enable our Companion Call advisers to reach out to you and provide information or assistance related to our service. To find out more about how we use your personal information, please read our supporter privacy statement.

 

(optional)
Enter a UK postcode to look up your address.
If preferred, enter or amend your address below.

About you (optional)

Do you care for someone with dementia? (optional)
Do you have a dementia diagnosis? (optional)

Contact details of the person you are referring (optional)

To sign up to Companion Calls on behalf of someone else, please enter the contact details of the person you are referring below.

 

We request an email address and phone number to enable our Companion Call advisers to reach out and provide information or assistance related to our service. To find out more about how we use your personal information, please read our supporter privacy statement.

 

Please enter the name of the person you are referring.
(optional)
Enter a UK postcode to look up your address.
If preferred, enter or amend your address below.
Please enter the phone number of the person you are referring.
Please enter the email of the person you are referring.

Your own contact details (optional)

About the person you are referring (optional)

Does the person you're referring have a diagnosis of dementia? (optional)
Is the person you're referring caring for someone with dementia? (optional)
What is your relationship to the person being referred? (optional)
How would you like the Companionship Service to help you feel more connected? (optional)

Emergency contact details (optional)