HCP Referral

HCP Referral Form

Please fill out the form below to refer your patient.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Patient's Details

Patient’s Name*
Patient’s Date of Birth

Referrer’s Details

Consent*
Please note: We are not an emergency service. If you need emergency input regarding this referral please link with the patient’s GP or contact Emergency Services as appropriate.

Privacy Statement

Cancer Care West is fully committed to adhering to the General Data Protection Regulation and the Data Protection Act 2018 and to respecting your privacy rights. This privacy statement sets out how we process personal data and the information you give to us. We are committed to protecting your personal information. You are not required to provide us with personal data unless you wish to avail of our services, receive updates about our work, or support our fundraising efforts.

This privacy statement explains:

  • Who we are and why we collect your personal data

  • For how long we hold your data and who receives it

  • How you may request the personal data we store about you

  • Who to contact about data protection issues in our organisation

Who we are and what we do
At Cancer Care West, we provide residential, psychological, and practical support services to those affected by a cancer diagnosis in a safe, nurturing, and accessible environment. Our vision is that no one should go through a cancer experience alone, and everything we do reflects this. We support individuals from diagnosis, through treatment and beyond. All of our support services are provided free of charge. This privacy notice is intended for individuals who avail of our services, volunteer with us, or participate in our fundraising activities.

Data we collect
We collect personal data that identifies you as an individual, such as your name, postal address, email address, and telephone number. We also collect data that helps us provide appropriate services, volunteering opportunities, and fundraising activities. We only collect data when you have provided it and consented to its use for the purposes outlined in this statement.

In collecting and processing your data, we commit to:

  • Putting you in control of your privacy and offering clear choices

  • Being transparent about how we collect and use your data

  • Protecting your data using appropriate technical and organisational measures

  • Complying with data protection laws

When you subscribe to our newsletter, visit our website, or complete contact forms, you consent to the use of that information as outlined here. You can unsubscribe at any time by emailing [email protected] with 'UNSUBSCRIBE' in the subject line, or by clicking unsubscribe links in our emails.

Your data will only be used for its original purpose or to meet legal or regulatory obligations. We do not share your personal data with third parties for marketing or fundraising purposes, nor do we store your information outside of the European Economic Area.

We may legally obtain and add third-party information to our user databases for service delivery purposes only. All individuals are responsible for ensuring that emails and attachments sent to us comply with the law. Unsolicited or illegal content will be reported and blocked.

Why we collect data
Personal data is used only for the purposes provided and any reasonable related purposes. It is treated with the highest standards of confidentiality and security. We use your information to offer suitable cancer support services and to manage relationships with donors, supporters, and volunteers.

We may share your data with the following third parties:

  • Sub-contractors – to help run our services under contract

  • Cloud service providers – to store data securely

  • IT backup providers – to retain data for continuity purposes

  • IT service providers – for data security and service management

  • Email service providers – for communication

  • Internal customer databases – to manage user records effectively

With your consent, we may also use your personal data to:

  • Provide cancer support services (e.g. accommodation, counselling)

  • Maintain donor and supporter relationships, including tax relief processing

  • Share information about volunteer events

  • Improve service levels

Legal bases for processing your data include:

  • Fulfilling a service or contract you have requested

  • Compliance with legal obligations

  • Legitimate interests of Cancer Care West, provided these do not override your rights

  • Your consent

  • Protecting your vital interests or those of another person

  • Performing a task in the public interest or under official authority

How long we hold data
We only retain data for as long as necessary for the purposes for which it was collected:

  • Cancer Support Centre users: Clinical notes retained for 10 years post final consultation

  • Other service users: Data held for 7 years

  • Volunteers: Data held while volunteering and for 1 year post-departure

  • Donors: Data held for 7 years in line with tax relief guidelines

Protecting your data
We take legal, organisational, and technical measures to protect your information, including various security protocols to prevent unauthorised access, use, or disclosure. However, while we take appropriate steps to protect your data once received, we cannot guarantee the security of data transmitted via our website. Transmission is at your own risk.

Our privacy notice does not apply to third-party websites linked from our site. We encourage you to review the privacy statements of any websites you visit.

Cookies
Our website may use cookies – small text files placed on your device – to personalise your experience. You may accept or decline cookies through your browser settings. Note that declining cookies may limit the functionality of our site.

Website usage
We collect information such as browser type, operating system, pages visited, and IP addresses using Google Analytics. This helps us understand visitor behaviour and improve the user experience. This data is aggregated and does not usually identify individuals.

Children’s privacy
We are committed to protecting children’s privacy online. Our website is not designed for or targeted at individuals aged 16 or younger.

Respecting your rights
You have the following rights under the Data Protection Act 2018:

  • Right of access – request a copy of your personal data

  • Right of rectification – correct inaccurate or incomplete data

  • Right of erasure – request deletion of data in certain circumstances

  • Right to restrict processing – limit how your data is processed in certain cases

  • Right of portability – request a copy of data for transfer to another provider

  • Right to object – to certain types of data processing, including direct marketing

To exercise your rights or make a data request, please contact us using the details below.

Contacting us
For data protection issues or data requests, you can contact us via:

  • Post: Cancer Care West, Inis Aoibhinn, University Hospital Galway, Galway

  • Email: [email protected]

  • Telephone: 091 545000

Complaints
If you are unhappy with how we handle your personal data, you have the right to lodge a complaint with the Data Protection Commissioner:

  • Post: Data Protection Commissioner, Canal House, Station Road, Portarlington, Co. Laois, R32 AP23, Ireland

  • Phone: +353 (0761) 104 800 or LoCall 1890 25 22 31

  • Email: [email protected]

Statement updates
This privacy statement was last updated on 01/12/2019. It is a live document subject to regular review. We reserve the right to update it at any time and encourage you to review it periodically.

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