Book a non urgent appointment with Gort Family Practice

This form is for NON-URGENT appointments for at least 2 days in advance.

For more urgent requests please call our surgery.

You must be a current patient of Gort Family Practice to use this form.

Please note blood tests must be performed before 11am daily.

First Name *

Last Name *

Email Address *

Mobile Number *

Date of Birth (DD/MM/YYYY) *

Appointment Type *

Preferred Doctor/Nurse *

Preferred Date *

Preferred Time *

We will confirm your appointment by email message only. *

I give permission to be contacted by email.

Thank you for your request. It has been sent and we will be in touch. Please note that your appointment request must be at least 2 days in advance. For more urgent requests please contact us by phone.

There was an error trying to send your message. Please try again later or call us.

Non-Urgent Appointments