HCP Referral

HCP Referral Form

Please fill out the form below to refer your patient.

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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.

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Cancer Care West was there for me when I didn’t know what to expect

Anne’s Story

Cancer Care West was like a haven in the midst of my treatment. I stayed at Inis Aoibhinn for 4 weeks while I was having Radiotherapy and used many of the services at the Galway Cancer Support Centre. When my treatment finished I wanted to say thank you to Cancer Care West for helping me through a difficult time.

I knew people in my community in Achill, Co Mayo would be receptive to fundraising for Cancer Care West and so organised a golf competition and a music night in Achill which raised €6,700. Cancer Care West was there for me when I didn’t know what to expect, it was a pleasure for me to be able to give something back.

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