For Consultant outpatient clinics, all GPs can refer to St James's Hospital using Healthlink.
Below are referral and request forms for specific services, listed by speciality.
Patient Referral Form for Lymphoma MDT
Patient Referral Form for SCT / Car-T Therapy to Lymphoid Team
Patient Referral Form for Stem Cell Transplant Myeloid Team Form
Patient Referral Form for Stem Cell Transplantation to Myeloma Team
Allograft: 100 day post transplant follow up form
Autoimmune Epilepsy panel request form
Biochemical Genetics Request Form
Bone Marrow Aspirate Request Form
BRCA test request and consent form
Consent for release of GP Lab Results
External Hospitals Request Form Microbiology Version 5
External Hospitals Request Form Microbiology Version 5 (Word document)
Familial Hypercholesterolemia Genetic Request and Consent Form
FISH Request Form for External Locations
Gonococcal Refernce Laboratory Request Form
GP Request Form Blood Sciences Version 13
GP Request Form Blood Sciences Version 13 (word document)
GP Request Form Histopathology
GP Request Form Histopathology (word document)
GP Request Form Microbiology Version 8
Haemochromatosis Gene (HFE) Mutation Analysis
Haemochromtosis Gene (HFE) Mutation Consent Form
Haemoglobinopathy Request Form
Histology form for Surgery in External Hospitals
PNH Screen Additional Information
Request form Alzheimers Biomarkers (word version)
Trauma referrals
Please contact the on-call team to discuss the most appropriate management for trauma patients, and where necessary the trauma referral form should be completed online here.
A referral form needs to be filled out by your GP and sent to the Memory Clinic at Mercer’s Institute for Successful Ageing.
Please use the following when referring patients to the Memory Clinic:
Referral forms are to be sent to the following address:
Memory Clinic
Mercer’s Institute for Successful Ageing
St James’s Hospital
Dublin 8
Trauma referrals
Please contact the on-call team to discuss the most appropriate management for trauma patients, and where necessary the trauma referral form should be completed online here.