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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.


Access to your medical records

The Coombe Women & Infants University Hopital recognises that patients who have received treatment and care here in the past may require a copy of their chart for reference when availing of treatment elsewhere.

A request for a copy of your chart may be sent by letter to:

The Patient Services Manager, Coombe Women & Infants University Hospital, Cork Street, Dublin 8, Ireland.

You can also email

Your letter/email should contain the following:

Hospital number/chart number, if you have it:

  • Your name at the time you were a patient, if it differs from your present name
  • Your date of birth
  • Your address at the time of treatment and your current address
  • Details of the records you are looking for (for example, requesting a copy of your maternity chart/ gynaecology chart/ baby chart)
  • Your mobile telephone number, in case we need to contact you
  • A photocopy of photo ID - either your passport or your driving licence.


If you are a third party looking for a copy of a living or deceased patient's chart, please telephone the Patient Services Department on 01 4085316 to discuss your request.


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

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

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