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.

HEADSHOT ELAINE

Elaine Corcoran

Elaine Corcoran is an oncology nurse at Cancer Care West since 2007. She completed her Higher Diploma in Oncology from UCD IN 2005. She has worked for the SAOLTA University Health Care Group in Galway and Castlebar as well as St. Vincent’s Private Hospital, Dublin. She has a specific interest in providing emotional support to cancer patients and their families and she completed a Certificate in the Psychology of Counselling from NUI Galway in 2013.

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