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.

Management-Richard-Flaherty

Richard Flaherty

Richard joined Cancer Care West in 2009 from his previous role as General Manager of Connemara Golf Club, and has over 15 years business management experience.  He oversees all aspects of Cancer Care West from Fundraising to Operations, and manages a busy and dedicated team delivering enhanced facilities and care to patients and their families.

Richard loves all sport, particularly GAA and soccer.  He coaches both Soccer and Gaelic football and is also a keen swimmer.  He has taken part in many fundraising challenges for Cancer Care West.

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