Maternity Registration Form

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Easy Online Maternity Registration

The Coombe offers Public, Semi Private and Private Care. To avail of Public or Semi Private Care please complete the online form below. For Private Care please click here.

Supporting Documents

To avail of free public maternity healthcare you must provide a copy of photographic ID plus a copy of one of the following:

A current valid medical card
Utility bill or other proof of address
Work permit or visa
Statement from your employer stating your contract of employment

Please submit these online, or bring copies with you to your first antenatal appointment.

For Your Attention

✓ GP referral for antenatal care is not required to register for maternity care.

✓ Documents will be shredded once checked so please do not submit originals.

✓Please note that failure to comply with the above may result in charges for your care.

✓ All invoices must be paid in full when leaving the hospital.

Please Note:

If you have pre-existing diabetes (type 1 or type 2) or a history of gestational diabetes in any pregnancy, please ensure to submit your registration form as early as possible and include this information in the comment box in your registration form. It is important that the team is aware of this as soon as possible to ensure early monitoring and support in your current pregnancy.

Maternity Registration Form

Please complete the below form in order to validate your personal details prior to attending for your scheduled appointment.

Privacy Notice

Please ensure you have read and understood this privacy information before submitting your form.

The General Data Protection Regulation (GDPR) applies to the processing of personal data. The Coombe Hospital is the data controller for your personal data.
To allow us to provide our services to you, we collect and process various categories of personal data, which may include:
- Personal details about you, such as date of birth, email address, address, next of kin, contact details.
- Notes and reports about your health needs/results of investigations such as x-rays and laboratory tests.
- Relevant information from other health and social care professionals, your carers or relatives.
You have certain legal rights concerning your personal data and the manner in which we process it, which include:
- A right to access a copy of your personal data.
- A right to request that we correct any inaccurate information, or update incomplete information.
The law stipulates that in certain circumstances personal data (including health information) may be disclosed. For example, in the case of infectious diseases or child protection. Also, as part of the birth notification process, your data including medical history will be shared with the General Registrar’s Office (GRO). This notification to the GRO allows for the birth of your baby to be registered by you. We may also disclose your contact details to the HSE and/or the Health Information and Quality Authority (HIQA) for the purposes of inviting you to take part in National Patient Experience Surveys.
Clinical data is collected in accordance with GDPR for clinical audit purposes. Your clinical data may be used to monitor and improve our services. Your personal data will be anonymised and you will not be identifiable from these audits.
The Coombe Hospital is a university teaching hospital, we work closely with Trinity College Dublin (TCD) and University College Dublin (UCD). All research projects are approved by the TCH Research Ethics Committee. Your health records may be accessed or screened by authorised researchers to assess if you are suitable for participation in a research project. If your clinical data is selected for use in research your consent will be required/obtained prior to inclusion in any research.
If you are holding a hard copy of your chart, you are responsible for the following:
- Keeping your chart safe and secure.
- Ensuring you have your chart with you each time you attend the hospital.
- Returning the chart if requested to do so by an authorised staff member of the hospital.
If for any reason you are admitted during your pregnancy, your chart will be retained by the hospital and returned to you on your next outpatient visit.

Departments & Services

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Help & Support

Appointments:
All appointments can be directed through Hospital reception: 01 408 5200, 24 hours a day
Health Insurance:
We operate a direct payment scheme with VHI, Laya Healthcare, Irish Life Health, Garda Medical Aid, ESB, Medical Provident Fund, and Prison Officers Medical Aid. If you are covered by any of these insurers, the relevant insurance forms are signed electronically on your admission to hospital.

Fees:
For more information on Fees - visit our Hospital Charges page
Useful Links & Resources:
Services & Departments Directory
Consultants Directory
Online Maternity Registration Form
Online Gynaecology Registration Form
Feedback Form
Your Hospital Bag
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