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Patient Forms

Download the forms our patients request most — where a doctor's assessment is needed, book an appointment and bring the form with you.

Download & Book

01

Maternity Benefit (Form MB10)

Application form for Maternity Benefit — the medical certification part is completed by your doctor.

Download PDF ↓
02

Health Expenses Relief (MED1)

Revenue claim form for tax relief on health expenses — completed by you, no appointment needed.

Download PDF ↓
03

Disability Allowance (DA1)

Claim form for Disability Allowance — includes a medical report section completed by the doctor.

Download PDF ↓
04

Carer's Allowance (CR1)

Claim form for Carer's Allowance — the medical declaration requires an assessment by the doctor.

Download PDF ↓
05

Driving Licence Eyesight Test

The eyesight report required for a driving licence application — the test itself is done at the clinic.

Download PDF ↓
06

Driving Licence Medical Report

The medical report required for a driving licence — requires a Driver Medical Examination (€80, see fees).

Download PDF ↓
Most of these forms require a doctor's assessment before they can be completed and signed — please book an appointment and bring the form with you, rather than dropping in. Contact us if further information is required.

Need a form
completed?

Book an appointment and bring the form with you.