HCP Referral

HCP Referral Form

Please fill out the form below to refer your patient.

"*" indicates required fields

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

Raise money through one of our charity challenges!

Take on one of our sporting challenges and help those affected by cancer.

There are so many ways to get involved.

Whether you are baking cakes, organising a table quiz or climbing a mountain, your support makes it possible for us to be there for more and more people with cancer.

Everyone Can Get Involved

There are many ways to support Cancer Care West, and every contribution is deeply valued.
You can take part in our fundraising events, organise your own, or donate any amount—either once or monthly. Every cent makes a difference.

Schools & Colleges

If your school or college would like to fundraise for Cancer Care West we would love to hear from you.

Companies and Corporations

From one off fundraising activities through to becoming charity partner we would love to work with you in a way that meets your corporate and staff needs.

Groups

It costs €1.5 million a year to keep our services going. Every single cent raised makes a difference and helps us to support people affected by cancer

Volunteers

By volunteering you can become a vital part of Cancer Care West

family

Donate

Your donation will help us to provide emotional, practical and residential support to people with cancer and their family and friends.

Fundraise

Want to support Cancer Care West but not sure where to begin?
Whether you're new to fundraising or a regular supporter, we’re here to help.

Organise An Event

The work of Cancer Care West is greatly supported by ‘Friends of Cancer Care West Committees’.

Wedding Favours

Donating to Cancer Care West on behalf of your guests on your wedding day is a wonderful way to make your day even more special.

Cake Sale or Coffee Morning

Organising a cake sale or coffee morning whether at work, home or in a local premises is a simple and enjoyable way of raising much needed funds for Cancer Care West.

Charity Challenge

Take on a challenge or dare one of your friends – the crazier the idea the better!

You know you would like to support Cancer Care West but are not sure where to start? Whether you are a first time or regular fundraiser we all need a little encouragement at times which is why we have put together some fundraising suggestions which have worked successfully for others. See our event ideas here or look into organising your own event.

If you already have an idea and want to get started, just get in touch to let us know about your event and to see how we can support you – [email protected]

Photo: REG GORDON

Why Choose Us?

Cancer Care West is here for those who need us. We are providing support to people to make sure no one goes through a cancer experience alone.

Participate

Eddy Liddy - Cycle

What would you like to do for Cancer Care West? Cancer Care West organise a number of events each year from walks and runs to swims, treks and climbs, and many of our events offer a sociable experience as well as a chance to challenge yourself. You can also join our team and take part in events like the Women’s mini marathon or Dublin City Marathon.

If you have a place in a sports event and would like to participate in support of Cancer Care West, please contact us for a sponsorship pack. If you haven’t confirmed a sports event yet, have a look at our organised events. Whatever you decide to do, thank you so much for supporting Cancer Care West.

Scroll to Top