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

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.

Salsa (Bachata) Class

Salsa (Bachata) Class

Cancer Care West Support Centre 72 Old Seamus Quirke Road, Galway
Dance

Group classes offering the opportunity to engage in aerobic exercise in a fun and enjoyable way. Classes can help to improve balance, strength, posture and breathing. Dances are done solo (as opposed to in pairs). Fitness assessment required in advance.

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