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 01 281 1662

Forms

Medical Card / GP visit Card Application (Form MC1)
Medical Card Application for over 70s (Form MC1a)
Health Expenses – Claim for Relief (Form MED1)
Dental Expenses – Claim for Relief (Form MED2)
Maternity Benefit Application (Form MB10)
Medical Report for Driver’s Licence (Form D501)
European Health Insurance Card Application Form
Drugs Payment Scheme Application Form
Long Term Illness Application Form

Newtown Medical Practice
Mountkennedy Town Centre
Newtownmountkennedy
Co. Wicklow

Tel: 01 281 1662
Out of Hours: 01 22 34 500
Fax: 01 281 1121

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