Child Referral Form

 

Adult Referral Form

 

School Referral Form

 

Self Referral Form

  

How do I get an appointment?

Consultation is by appointment only, following the receipt of a completed referral form. Please email for an information pack (referral form and further information) if you are unable to download the forms from the website. Referrals can be received from all health professionals, schools or families. Once the completed referral form is received back, an appointment will be sent out.

In the event that a health professional makes a referral, the information pack is sent to the individual/family for completion. Therefore, health professionals need only send a letter to Dr Penny Rogers requesting consultation with their client/patient. 

Appointments are arranged at MPCTS office at Block 6, Central Business Park, Clonminch, Tullamore, Co. Offaly.

Download Referral Forms Above.

Please note

The service is unable to accept referrals for children from the Laois/Offaly catchment area. This is to avoid any conflict with Dr. Rogers HSE role.

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Midland Psychology

& Cognitive Therapy Service