Blackglen Medical

Adult Patient Registration Form

In order to provide for your care, we need to collect and keep information about you and your health in your personal record. The information will be used to create your personal medical record on the practice computer. Our practice is consistent with the Medical Council guidelines and the privacy principles of the Data Protection Acts.

To avail of certain government schemes ( e.g. social welfare certificates ), it is necessary to provide your PPSN.