Request a copy of your radiology scan

Get in touch

If you've had a scan at Hermitage Clinic and would like a copy, enter your details below. We'll post a CD to you. All CDs will be posted within 4 working days of receiving your request. If you require an urgent copy of your scan, visit us in person at the Radiology department. A member of our team will be able to produce a CD copy for you within about 15 minutes.

First name

Last name

Phone number

(in intl format e.g. +353 85 012 3456)

Address

City

County

Eircode

Patient first name

Patient last name

Patient middle name

Date of birth

Patient address

Patient address 2

Patient city

Patient county

Patient eircode

Scans required

Date of scans

Reason for scan request

Radiology Report

Scan Images