Useful Forms

Fitzwilliam Medical Centre conveniently located in Dublin city centre

20 Years Experience

Our Doctors partake in continuous education to ensure delivery of a comprehensive and innovative healthcare service.

Book An Appointment

  01 678 5100

Make An Appointment

Repeat Prescription

We operate a 48 hour request turnaround for prescriptions.

Repeat Prescriptions

Our Location

Click below to view our clinic
location & opening hours

Fitzwilliam Medical Centre

Useful Forms

Medical Card application (MC1)

Medical Card application for over 70’s (MC1A)

Medical Card application for under 6’s

European Health Insurance Care Application form

Long term Illness application

Drug Payment Scheme Application form

Paternity Leave application

Maternity Leave application

My Pregnancy Book

Maternity Benefit form

Paternity Benefit application

Health Expenses Med1 form

Driving licence Medical report form (D501)

Driving licence eyesight report form

Contact Us

At Fitzwilliam Medical Centre our patient’s needs are at the heart of everything we do

View Our Services

Fitzwilliam Medical Centre,
79 Fitzwilliam Lane,
Dublin 2

01 678 5100

Out of hours Eastdoc:

01 209 4021


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