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professional. private. personal.

Griffith Avenue Practice

Call us on: 01-8373611

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New Patient Registration Form

If you are looking to join the practice, please complete the form below and a member of staff will aim to get back to you within 7 days.

Name

Date of Birth

Mobile Number

Email

Address

Existing GP Name and Address

I agree to the use of my email/ phone nuber in keeping with the Data Protection Policy of Griffith Avenue Practice:

Thank you for submitting your registration request

Griffith Avenue Practice

01-8373611

Hours:

Monday* - Friday

09.00 - 12.00; 14.00 - 17.00

Outside these hours please call D Doc: 0818 224476

*Bank Holidays/ Public Holidays please call D Doc as above

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