Patients - General Application (restricted use)

General Intake Form 

Please fill in all the information as accurately as possible.

   Dr. Jody Shanahan-Prendergast

M.D., MRCGP, FRACGP

Irish Medical Council Register Number: 425861

How it Works?
Just €25 (100% money back guarantee).
Online consultations with Irish based doctors.
Discretely posted in a plain envelope with no branding.
Our doctors issue a 6 month prescription if medically safe and suitable.
Valid in any Irish pharmacy to buy your medication.
No risk, 100% refund if our Doctors cannot help you.
The information that you provide is covered by the same patient-doctor confidentiality as in a normal face to face consultation.

Ok, Let's Start