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Group Booking Form

Fill in the form below to make a group booking, or get more information on what services the TMB can offer your travelling group.

THIS FORM IS FOR GROUPS OF 10 OR MORE ONLY.
Otherwise please book an appointment here.

NOTE: Fields marked with an asterisk (*) are required.
Select Clinic Closest to Your Location:
 *
Name of Organisation / School / Group: 
 *
Contact Name: 
 *
Contact Address:
*
Contact Tel:
 *
Contact Fax:
Contact Email:
 *

Destination:
(Please indicate specific locations if possible)

 *
Date of Departure:
Total Duration:
days
If Known, Numbers:
(Please give approximate number if accurate number is not known at this stage)
* over 18 years of age
* between 16 & 18 years of age
* under 16 years of age
If Known, Total No. of
 Male:   /  Female:
Purpose of Trip:
If 'other', please specify:
Please provide any further Specific Details which will be important in Decisions regarding health issues for your proposed trip:
 

For more information, please contact our Groups Coordinator, Miriam Edge.
Tel: (01) 271 5200    Fax: (01) 271 5210    Email: miriam.edge@tmb.ie

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