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.

FR Dungeons

Organising the event has helped me to deal with Mags’ diagnosis and gave me a purpose during a difficult time.

Ronan’s Story

A few months after my wife Mags was diagnosed with cancer I decided to raise some money for Cancer Care West. I run a hobby store and board games café business in Galway and along with some friends decided to organise a a 24 hour board games marathon. With the support of the gaming community in Galway we raised over €12,000 – our suppliers donated prizes, our regular customers raised sponsorship and we held raffles and an auction live on Facebook.

We have started organising next year’s event for Cancer Care West and the funds will help Cancer Care West to pay for the numerous services they provide. Organising the event has helped me too – it helped me to deal with Mags’ diagnosis and gave me a purpose during a difficult time.

More Inspiring Stories

Scroll to Top