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056 776 2329

Become A Patient

IMPORTANT NOTICE BEFORE BOOKING AN APPOINTMENT

Practice Standards of Behaviour

By becoming a patient of Christie Dental you are bound by the practice standards of behaviour and respect. Any infringement of these standards whether by phone, email or in person will result in the forfeiture of appointments and deletion from the practice patient list.

Failed Appointment Fees

A €50 fee will be charged if you are more than 10 minutes late to your appointment.
A €50 fee will be charged if you miss your appointment without prior notice.

Medical Card Patients

If you are claiming under the Medical Card scheme, you must bring your valid Medical Card to your first appointment.

Translator Requirement

If you require a translator, you must bring one with you to your appointment.
Failure to do so will result in the forfeiture of your appointment and any future scheduled appointments.

Rescheduling & Cancellations

If you need to cancel or reschedule your appointment, please contact us at least 24 hours in advance to avoid penalties.

To become a patient of Christie Dental Kilkenny simply fill in the Medical & Dental Questionnaire below

Step 1/5:

Medical & Dental Questionnaire

Please complete this form in English only

*For mobile devices, tap the year on top left of popup calendar to select DOB year
I Consent to this practice Collecting and maintaining a record of my PPSN for the purposes of verifying my eligibility for dental benefits and where appropriate and the submission of claims for payment.
I Consent to this practice Collecting and maintaining a record of my Medical Card for the purposes of verifying my eligibility for dental benefits and where appropriate and the submission of claims for payment.

Terms and Conditions – Become a Patient

Please read and accept the terms and conditions below in order to proceed and complete our patient registration medical & dental questionnaire.
***If you click on ‘I do not accept’ you will simply be redirected back to our home page.***

 

I agree to:

 

– Pay a failed appointment fee of 50 Euro if i am more than 10 minutes late to my appointment

– Pay a failed appointment fee of 50 Euro if I miss my appointment

– Bring my Medical Card to my first appointment if claiming under Medical Card

– Forfeit/lose my appointment and any further appointments if I do not have a translator with me as required

– I Agree To be bound by the practice standards of behaviour and respect. Any infringement of these standards whether by phone, email  or in person will result in the forfeiture of appointments and deletion from the practice patient list.