Clinical assessment referral

Please use this form to request a clinical assessment for an adult (18 and over). The assessment is to understand the difficulty and advise on care. You receive a letter with findings and recommendations; it is not an expert report and is not written for legal proceedings.

If you need an expert report for a claim or legal proceedings, please use the medico-legal referral form instead. If you are not sure which you need, email info@amckiernan.ie.

If you need urgent help

This service cannot respond to urgent needs. If you need help now:

  • contact your GP, or your out-of-hours GP service
  • go to your nearest Emergency Department
  • in an emergency, call 999 or 112
  • call Samaritans free, any time, on 116 123
  • text HELLO to 50808, free, any time

Referral form

Questions marked (required) must be answered.