Register your Interest

    Step 1

    Step 2

    Step 3


    Do you/applicant intend to register as a GMS or GP visit card (Over 70s, Under 8s or Carers) ?

    Yes, however I fully accept it’s not a guarantee and it could be with Dr Sreelakshmi Enduluri or Dr Swetha Ellanti (T&C apply)No

    *Terms of Registration


    Given Dr Agarwal has reached the capacity to take on new patients on his GMS panel, you may wish to register with Dr Sreelakshmi Enduluri or Dr Swetha Ellanti.


    LIMITATION ON NUMBERS by HSE
    The number of persons whose names may be placed on the list of the practitioner (or, in the case of a practitioner who has agreements with two or more areas within the Health Service Executive, the total of the numbers which may be placed on the lists for those areas) shall not exceed 2,000 save where the Health Service Executive, in exceptional circumstances, after consultation with the Irish Medical Organisation, decide to apply a higher limit. Where a medical practitioner who has entered into an agreement holds or obtains an appointment under the Health Service Executive, the Health Service Executive may specify a limit lower than 2,000 for the number of eligible persons on the list or lists of that practitioner.



    Please fill the form multiple times for each member that you wish to register.

    I will fill this form separately for each family member.



    First Name*
    Surname*
    Mobile Phone*
    Gender assigned at birth*
    Address Line One*
    Address Line Two*
    City*
    Eircode* (Without Space)
    Email ID*
    Date of Birth*
    PPS Number*
    Next of Kin Name
    Relationship to Patient
    Do you have private health insurance? YesNo
    Name and address of previous GP*
    Do you consent to receiving communication from us through email or text message and accept the non-secure and non-reliable nature of those modes of communication?* YesNo


    Undertaking*
    Medical Records Transfer Request form
    5 + 6 =