Book care with the Pharmhealth team

Consent can only be provided by a parent or legal guardian where the service is being provided to a child aged under 16 years. In order to avail of the Common Conditions Service in the pharmacy you must consent to the following statement:

I wish to use the Common Conditions Service.

I understand that further information about the Common Conditions Service is available on the HSE website at HSE.ie.

I understand that to use this service, I must complete a consultation with the pharmacist in the pharmacy.

I acknowledge that the pharmacist will only prescribe or recommend medication if they determine that I have a condition listed under the HSE Pharmacy Common Conditions Service, and only in accordance with their clinical protocols. Any treatment offered will depend on the information I provide and whether it is suitable for me.

I confirm that all information provided in this form, as well as any details I share with the pharmacist during my consultation, are accurate to the best of my knowledge.

I understand that if the pharmacist issues a prescription, I may have it dispensed at any pharmacy of my choice.

I understand that after my consultation, the pharmacist may decide not to prescribe or recommend any medication and may instead refer me to another healthcare professional.

I understand that a professional service fee of €20 applies to this service.

I understand that additional fees may apply for any prescribed or recommended medication unless I qualify for coverage under a Community Drugs Scheme (e.g., Medical Card or Drugs Payment Scheme), in which case scheme levies or thresholds may apply.

I acknowledge that my date of birth, phone number, and (where relevant) community drugs scheme details will appear on the prescription.