Prescription Request Form - Dr Brigid Halley

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€20.00

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This is for private clients only, thank you.

Private Patients Click Here Please

Full Name *

Date of birth? *

Name Of Your Pharmacy *

Address Of Your Pharmacy *

Are You A: Select all that apply Private Patient - YES

Medication - Please type your medication including dosage, number of tablets/doses per month and frequency here. One line for each medication.

By using this form you agree with the storage and handling of your data by this website. Select all that apply Yes

Quantity

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Location

Cashel Medical Centre, Feehan's Rd, Cashel, Co. Tipperary, E25 RD21

Contact Us

062 61 715

Monday 09:00 – 12.30 & 14:00 - 17:00
Tuesday 09:00 - 12:30 & 14:00 - 17:00
Wednesday 09:00 - 12:30 & 14:00 - 17:00
Thursday 09:00 – 12.30 & 14:00 - 17:00
Friday 09:00 – 12.30 &14:00 - 17:00
Emergencies only 5-6pm

CAREDOC 0818 300 365