Supporting Patients - Referral Form for Patients
Model of Care
How do I access Dove House services?
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You must have a diagnosis of illness that is life threatening.
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You do not need to have a terminal diagnosis.
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You currently may be having curative treatment for your illness.(eg. surgery, chemotherapy, radiotherapy) and need support through this time.
Do I need a referral from my doctor?
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No, you can refer yourself, or you can be referred by a family member or friend, your GP or other health care provider who is known to you and has your permission.
If you wish to access Dove House services, please complete the below form:
All services are free of charge
If you wish to speak to someone regarding accessing the service, please call
09 575 4555.
