Nursing Home Registration Form

Why do we need this information?

In order to set you up with a Healthmail account we need to ensure you are a Registered Nursing Home. The information you provide will be authenticated by Nursing Homes Ireland. We need your existing email account and mobile phone number so that we can send you a username for your new Healthmail account by email and a password by text message.

Personal Details About your Nursing Home
E.g. 001234
E.g. (01) 123 4567
   
E.g. 0012345
       
 
Current Email Address
 
Please use an email address accessible by the Nursing Home.
Confirm Email Address (Current)

 

Terms & Conditions  
I agree that my information can be viewed by Nursing Homes Ireland to authenticate me as eligible for a Healthmail account.