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Maternity Registration Form

Maternity Registration Form

Even if you've had a baby at the Coombe in the past, all maternity patients must fill in a Patient Registration Form. Please return the completed form to us in order to receive your first appointment. Click the word 'more' (below) to download a copy of the form.


Information for GPs & Referring Hospitals


In order to help you provide us with all the relevant information about your patient, the Coombe Women & Infants University Hospital has created a Maternity Registration Form for women whose pregnancy you have confirmed and whom you wish to refer to the hospital. You can download this form here: Maternity Patient Registration Form

Your patient must complete this form, which will help us to have the patient's full details on file before she attends, and will also help us to ensure your patient receives an appropriate and timely appointment.

Please advise your patient that her appointment will only be processed when we receive the completed form.

The form can be posted to the Central Appointments Office, Appointment Scheduling Department, Coombe Women & Infants University Hospital, Cork Street, Dublin 8 or faxed direct to the Outpatient Department on 01 4085560. Please make sure you retain a copy for your own records.

For Perinatal Ultrasound referrals, please click below:

GP high risk referral form



GPs can send General Gynaecology eReferrals through Healthlink, the HSE's national web based messaging project. This means your practice does not have to worry about sending faxes or getting your patients to deliver referral letters.

If sending a referral by An Post, please address the envelope to the Central Appointments Office - Gynaecology

For specialised Gynaecology referrals, or if your practice is not connected to Healthlink, you may refer your patient as you normally do with a GP Referral letter, or by using the customised GP Referral Form. You can download this form here: GP Referral Form


TOP providers can send appropriate referrals using the email address

For urgent queries, call the Options in Pregnancy Clinic on 01 4085462 ( Monday to Friday 8am - 4pm, answering machine service after hours)

For Primary Care Blood Group for TOP please click

Coombe Request Form

Blood Group for TOP- 2020 GP Information Sheet




Coombe Women & Infants University Hospital
Cork St.
Dublin 8.

Tel: +353-1-408 5200
Fax: +353-1-453 6033

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