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46 Manor Street, Stoneybatter, Dublin, D07 XT38

McFadden McFadden

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01 817 8400

Email Us

[email protected]

46 Manor Street, Stoneybatter, Dublin, D07 XT38

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  • Home
  • About Us
  • Services
    • Covid-19 Vaccination
    • Viagra Connect
    • Morning After Pill
    • Blood Pressure Screening
    • Smoking Cessation
    • Blister Packing Service
    • Prescription Collection
    • Healthmail
    • Photo Printing & Passport Pictures
  • Latest News
  • Contact Us

McFadden Covid 19 Vaccination form

  • McFadden Covid 19 Vaccination form




  • Have you had anaphylaxis (serious systemic allergic reaction requiring medical intervention) following a previous dose of any vaccine or any of the constituents of the COVID-19 vaccines, including polyethylene glycol or polysorbate 80?










  • I (as a patient aged over 16 years or as a parent or guardian of the patient aged 15 years or under) have read and understand the vaccine information provided. including known side effects.

    I understand that the COVID-19 vaccine is only recommended to be given between week 14 and week 36 of pregnancy.

    I understand that I am giving consent for the administration of a COVID-19 vaccine including a 2nd dose.









Contact Info

46 Manor Street, Stoneybatter, Dublin 7

01 817 8400

[email protected]

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Monday-Friday : 8.30am - 6.30pm
Saturday : 9am - 5pm
Sunday : CLOSED
Bank Holidays : CLOSED

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