New Patient Enquiries

We have limited capacity to take on new patients at present. Priority will be given to enquiries where patients do not currently have a GP in South Dublin. Similarly, we are not in a position to take on new patients outside of our catchment area due to capacity constraints and reasonable access to out of hours services in the locality.

All new patient queries will be reviewed by the partners in the practice. Please note registration is not complete until confirmed in writing to you. Please complete the new patient enquiry form below.

Practice Policies

Please note, we have a number of policies we would like to make you aware of before joining the practice:

Our appointment times are generally up to 15 minutes, as such we can usually discuss only 2-3 issues at most (depending on complexity) during this time to sufficient detail to manage these issues appropriately - if you feel you will need more time, please book an extended consult or come back for a second visit. Whilst we do not want to be ‘clock-watchers’ it can be very disruptive to the working day and cause delays in the waiting room.
It should go without saying but we will not tolerate any form of abuse of our staff members. Our team work exceptionally hard at providing an efficient service under our direction and instruction, however they should reasonably expect to work in an environment where they are not shouted at or treated in a disrespectful or offensive manner. Whilst we understand accessing healthcare can at times be stressful, we ask that our staff are treated courteously and in turn we would expect they treat you the same way. If we are made aware of unacceptable behaviour, we will act accordingly and may request that you find another GP practice.
Please note, we will try and fit in someone if urgent, however it is not always possible to do so - due to increased demand on GP services, routine appointments are regularly running to approximately 1 week, we will always have same day appointments available for urgent cases but these are usually booked up early in the day. If your issue is not truly urgent, please do not take up one of these appointments in place of someone else who may need it more.
By joining the practice you are a patient of all healthcare providers in the practice. Waiting times to see one of the partners can be longer than one of our other doctors. Please do not delay seeking healthcare advice if you cannot see your chosen doctor and the issue is urgent.
We have a policy of not prescribing benzodiazepines (“z” drugs) or drugs of an addictive nature where at all possible. This policy is particularly strict for new patients with whom we will not be as familiar due to the increased frequency of ‘doctor shopping’ to get prescription medication.
It is practice policy that all patients on prescription medication attend at least annually for a check up and to evaluate the need for ongoing prescription and make changes as required.

New Patient Enquiry Form

Please complete the form below. Please note - a separate form is required for each patient (ie for a family of 3, 3 separate forms will be required)

Name

First Name

Last Name

Date of Birth

YYYY

Medical Card Number (if applicable)

GMS/Doctor Visit Card number - if none, write 'none'

PPSN

Required as patient identifier and to access certain government services

Phone (mobile preferably)

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Occupation

Current GP

Medical History

Please include a brief history of any active or significant medical history

Medication list

Please include a list of all medications you are currently taking.

Drug Allergies

Message/further information

Please provide any further information or comments that may be relevant to your application to join the practice.

Privacy & Data Protection

Our privacy policy can be found on our website : www.churchtownfamilypractice.ie/privacy-policy In order to operate an efficient service and to be compliant with data protection legislation, we would like your consent to contact you by the following methods if we need to get in touch with you or send periodic updates on practice services/hours. Please check the boxes to provide your consent to be contacted by any of the following methods.

Text Message

Phone

All of the above

None of the above

Confirmation of details and consent to retain data

I confirm that the information provided above is true and correct and consent to my data being held on file as per the practice policy