Submitting a Service Request

Requests for services are confidential and allocated according to resources and availability of funding.  Enquiries can be submitted to the Services Manager of the county you request the service in. The service manager or dementia nurse specialist will then arrange to visit with the Client and Primary Carer.  Needs are then assessed and places allocated according to availability. In some instances Client’s may be placed on a waiting list with service allocated once resources become available.

The first step to availing of our services is to fill in and return a referral form. You can download the form below and send back to your local Western Alzheimers office or call the office to request one to be posted to you. Please note a letter confirming a dementia diagnosis is necessary and must be sent in with the application form.

Call 094-93 64 900 for a Referral Form








Contact the office nearest to you with any questions.


Western Alzheimers Head Office, Ballindine, Co. Mayo

Tel: 094 93 64900 Fax: 094 93 64946 Email:


Western Alzheimers Colonial Buildings, Eglinton St., Galway

Tel: 091 565 193 Fax: 091 569 223 Email:


Western Alzheimers Goff Street, Roscommon

Tel: 090 66 27816 Fax: 090 66 30501 Email:

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