Get The Support Your Looking For

We support anybody who lives in the North West Region who has been affected by a diagnosis of cancer or other life-limiting condition. All clients must have a reasonable level of independence and cognitive awareness to engage in the psychological support we offer. Once we have received a referral form, we aim to make contact within 7 days.

Self-Referral Form (Client)
Please tell us how you heard about Beechwood *

Diversity Indicators

Your Information

Email helps the charity to reduce paper and postage costs.
How can we contact you?
Full Mobility *
Limited Mobility *
Have you attended Beechwood before?
We offer a very limited transport service to people who live in Stockport. Please tick if you would like us to try and arrange transport.
N.B. We cannot guarantee this will be possible as it is on a volunteer driver basis.

Emergency Contact Details

Diagnosis Information

Further helpful information

GDPR Consent *
Beechwood Stories