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Name (s)
*
Number Attending
*
Email
*
Phone
*
Purpose of Appointment
Clinic
Blackrock
Dundrum
Galway
Grafton Street
Blanchardstown
Carlow
Clarehall
Cork
Cork (Little Island)
Enniscorthy
Gorey
Kilkenny
Limerick – Castletroy
Limerick – Mungret
Louth
Ongar
Phibsborough – Mountjoy St
Sligo
Waterford
Wicklow
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
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Hours
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How did you hear about us?
*
Please select an option
– Select from list –
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General Practitioner
Newspaper Article
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Referral Other
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