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PLEASE NOTE: This referral form is intended for use by Professionals such as GP's, Speech & Language Therapists, Teachers & Mental health Professionals. If you are an individual looking to self refer please do so through the contact us page.

Please complete the details below to make a referral to My Psychology Ireland. A member of our team will respond to both you (the referer) and the individual to confirm that we have received the referral.

Thanks for submitting!

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