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Request a new appointment

Blackrock Health offers fast access to expert medical treatment, with the highest possible standards of care.

You can attend our three hospitals, Blackrock Clinic and Hermitage Clinic in Dublin, Galway Clinic in the west, and our diagnostic clinic in Limerick. 

Please note that to make an appointment for most of our diagnostic tests, treatments, and procedures, you will first need a referral from your GP. 

Patients - Submit your referral

Patients can use this form to request an appointment. Please provide your details and upload the referral from your GP.  After submitting the form, your referral will be processed, and a member of our team will get in touch with you. 

If the service you're seeking doesn't require a GP referral, simply input your information, and the right department will contact you. 

If you're uncertain, refer to the appropriate service page in our Treatments and Procedures section to confirm how to schedule an appointment for the healthcare service you require. 

Important Notice: We are not able to offer medical advice via this form. 

This form is not for GP submission. GPs please refer from the Direct Referral Forms section of the Healthcare Professionals page.  
Patient Details
Referring Doctor's Details (if applicable)

Referral Letter

Most appointments require a referral letter which you can upload here. If your service is not listed or if it doesn't require a referral letter, please check the service page for more information.
One file only.
5 MB limit.
Allowed types: txt, rtf, pdf, doc, docx.

Additional Notes

Any additional information relevant to your condition? Please indicate if this is your initial appointment or renewal appointment.
 
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