New Patients

How to join Kilmainham Medical Centre

We are currently accepting new patients on a limited basis and welcome you to apply to join our practice. To get started, simply fill out the registration form below. Your application will be securely directed to our team for review.

If you are unable to complete the form online, paper forms are available at our reception. Please note that we are unable to send forms by post or email.

New Patient applications are reviewed weekly, and we will notify you by email or text regarding the outcome. Your registration will only be confirmed once you receive official acceptance from our practice.

Due to capacity limits and our commitment to providing quality care to patients in the Inchicore area, we may not be able to accommodate all applications. Thank you for your understanding.

How to join Kilmainham Medical Centre

New Patients Application Form

Your Details:

Gender *:

Why have you applied?

Medical Card / Doctor Visit Card Status:

Medications:

Relatives in Kilmainham Medical Centre:

Details of dependents under 16 you are also applying for:

Please Read:

I consent to being contacted by Kilmainham Medical Centre in relation to this application (tick box) and I confirm that the above information is correct.
I understand that applications are reviewed once a week, and that I am not a patient of the practice until I receive confirmation from Kilmainham Medical Centre that my application has been successful.

* Required field.

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