Service Enquiry Form

If you would like to register your interest in one or more of our services for yourself or your child, please fill out the form below. A member of the team will be in touch as soon as possible.

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  • When we receive this form, we will make an appointment with you to talk about your / your child’s needs, likes and dislikes in depth.
  • ShortBreaks for Disabled Children Children under the age of 19 need to be registered with Essex ShortBreaks and be issued with a ShortBreaks Passport Number to access our services. Please provide the number below. Register here If you are over 19, please leave this blank.
    Would you like to stay up-to-date with Accuro (Care Services) latest service information, news and upcoming fundraising events? Please tick here to agree to Accuro (Care Services) storing your personal data; this will not be shared with any third parties, and you can opt out from our mailing list at any time.