Send message to Clinic Manager

Have you attended this clinic for a consultation with a Doctor before now*
- YES
- NO
When did you last attend (month and year)
CONFIDENTIAL message for the Clinic Manager*
click to send a message. We will aim to respond within 48 hours. If you are in need of urgent medical attention then please attend the Emergency Department of any hospital. Provide enough information to allow the Clinic Manager to fully consider your question so that the Clinic Manager will be able to respond to you by SMS.
Patient Name*
Patient Mobile Telephone Number*
If your mobile is NOT Irish then include your country code, city area code and mobile number
REPEAT Patient Mobile Telephone Number*
Type carefully and make sure your number is accurate
Patient Email*
We usually communicate with you by SMS Text Message but if we send you an email it is sent from NoReply@NoReply.ie If you cannot find it in your Inbox please check your SPAM or JUNK folder
Repeat Patient Email*
Type carefully and make sure it is accurate
Patient Date of Birth (in format Day then Month and then YEAR)*