1st Floor, 71 Deerpark Road, Mount Merrion, Blackrock, Dublin | 01 2881297 | mountmerrionmedical@gmail.com
Patient Registration Form
1. Fill in the patient registration form, attached here.
2. Email your completed to mountmerrionmedical@gmail.com
3. If you would like to make an appointment for a consultation, please specify this in the email. Thank you
The following cookies load by default:
Strictly necessary cookies
These cookies are essential for visitors to be able to browse the website and use its features. None of this information can be used to identify visitors as all data is anonymized.
Site session
Purpose: To remember different visitor preferences on the website.
Duration: For duration of browser session.
Preferred language
Purpose: To be able to provide the website in the visitor's preferred language (if the website contains multiple languages).
Duration: 1 year.
Currency
Purpose: To be able to show prices in the currency matching the visitor's preferences.
Duration: 30 days.
Google Recaptcha
Purpose: To be able to validate whether the visitor is human and to limit the amount of spam from contact forms.
Duration: 1 year.
Provider: Google.
Third-party cookies
These cookies collect information about how visitors use the website, like which pages they've visited and which links they've clicked on. None of this information can be used to identify visitors as all data is anonymized.
ga
Purpose: Registers a unique ID that is used to generate statistical data on how the visitor uses the website.
Duration: 1 year.
Provider: Google.
gid
Purpose: Registers a unique ID that is used to generate statistical data on how the visitor uses the website.
Duration: 24 hours.
Provider: Google.
gat
Purpose: Used by Google Analytics to throttle request rate.
Duration: 1 year.
Provider: Google.
We also integrate with social platforms on this site that allow you to connect with your social network in various ways. Social media integration will set cookies through the website which may be used to enhance your profile on social media sites or contribute to the data they hold for various purposes outlined in their respective privacy policies.
Strictly necessary cookies
These cookies are essential for visitors to be able to browse the website and use its features. None of this information can be used to identify visitors as all data is anonymized.
Site session
Purpose: To remember different visitor preferences on the website.
Duration: For duration of browser session.
Preferred language
Purpose: To be able to provide the website in the visitor's preferred language (if the website contains multiple languages).
Duration: 1 year.
Currency
Purpose: To be able to show prices in the currency matching the visitor's preferences.
Duration: 30 days.
Google Recaptcha
Purpose: To be able to validate whether the visitor is human and to limit the amount of spam from contact forms.
Duration: 1 year.
Provider: Google.
Third-party cookies
These cookies collect information about how visitors use the website, like which pages they've visited and which links they've clicked on. None of this information can be used to identify visitors as all data is anonymized.
ga
Purpose: Registers a unique ID that is used to generate statistical data on how the visitor uses the website.
Duration: 1 year.
Provider: Google.
gid
Purpose: Registers a unique ID that is used to generate statistical data on how the visitor uses the website.
Duration: 24 hours.
Provider: Google.
gat
Purpose: Used by Google Analytics to throttle request rate.
Duration: 1 year.
Provider: Google.
We also integrate with social platforms on this site that allow you to connect with your social network in various ways. Social media integration will set cookies through the website which may be used to enhance your profile on social media sites or contribute to the data they hold for various purposes outlined in their respective privacy policies.