Refer a patient

Refer a patient to Marie Curie Hospice, Belfast

Who can refer a patient


If you are a healthcare professional, you can refer a patient to the Marie Curie Hospice, Belfast.

  1. Review the referral criteria
  2. Complete the referral form 
  3. Fax or post the referral form to the address at the top of the form.

Further contact details are available online.

Referral criteria

Review the referral criteria before completing the referral form.
Download file
Referral criteria (PDF, 57KB).
Referral criteria (PDF, 57KB)
Category: Documents
(PDF format, 57KB)

Referral form

Submit this form by fax or post.
Download file
Referral form (DOC, 91KB).
Referral form (DOC, 91KB)
Category: Documents
(DOC format, 91KB)
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