Request Appointment - TMB - Travel Health Clinics

Name (s) *

Number Attending *

Email *

Phone *

Purpose of Appointment

Clinic

Purpose of Appointment

COVID-19 Antibody Testing
Use this option if you need to be tested to see if you have had Covid infection previously.
COVID-19 Clearance Certificate
Use this option if you need a confirmation (usually for travel) that you do not have Covid-19 at this point in time
[IF YOU ARE CURRENTLY ILL IT IS ESSENTIAL THAT YOU IMMEDIATELY SELF ISOLATE AND CONTACT THE HSE TO FOLLOW NATIONAL GUIDELINES]
Vaccinations for Holiday / Business Travel
Use this option if you are travelling away from Ireland
Health Screening Pre and Post Travel
Use this option if you need a medical screen before travelling overseas or you have returned back home
Influenza / Shingles Vaccination
Use this option to make an appointment to receive the Influenza vaccine (and / or cover against Shingles / pneumococci)
Occupational Vaccines
Use this option if you need to have vaccines for your work such as cover against Hepatitis B, Tetanus etc
NGO / Assignment / Charity Vaccines
Use this option if you are travelling with a group (schools, aid and development, charity walks etc)
On-Site Larger Group Appointments (>20)
Use this option if you need to make an appointment for larger groups (>20) where all the individuals can attend at the same time (in-clinic or at your location)
Health Check Laboratory Checks
Use this option if you want to have any of our laboratory based health checks carried out
[You will need to bring these results to a healthcare professional to discuss]
Other – no trip at this time
Use this option if your appointment requirements don’t easily fit any of the above options

Date *

Hours *

Minutes *

How did you hear about us? *

Referral Other

Travel Destination *

Are you an existing client of TMB? *YesNo

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