Online Self Referral

online Self Referral

How to make an appointment

When you submit this form, your information will be reviewed and an appointment will be made for you. Your appointment details and information will be emailed to you through our online patient portal. Should you have any queries or if the appointment date does not suit, please contact us via the patient portal.


Self Referral Form

Printable Forms

Referrals can be sent by Post to:
Merrion Fertility Clinic,
60 Lower Mount St,
Dublin 2

Referrals can be sent by email to:

Online Referral

Semen Analysis

Price List

Please see the full Merrion Fertility Treatment pricelist.

Price List & Referral Forms