Referral Form for Health Organisations

Model of Care

Is your patient eligible for Dove House services?

  • They must have a diagnosis of illness that is life threatening.

  • They do not need to have a terminal diagnosis.

  • They may be having curative treatment for their illness.(eg. surgery, chemotherapy, radiotherapy) and need support through this time.

Please complete the below form to refer your patient.

If you are a patient - please click here

All services are free of charge

What Services do we offer?

If you wish to speak to someone regarding accessing the service, please call 09 575 4555.