Make A Payment

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Payment Form

- Step 1 of 2

Card Payment Card

Patients Name *

First

Last

Please specify the patients name here.

Email *

Date Of Birth *

Phone Number *

What is the payment for? *

Payment Amount *

Please note for €20 enter 20, for €30 enter 30 etc.

Name *

First

Last

Total of Payment

0,00 €

Please note €20 simply enter 20, for €30 enter 30 etc.

Credit Card Details *

Card

Name on Card

Note: Payments are handled by Stripe payment gateway, Rathangan Medical Centre do not hold card details of customers.

Monday 9am–1pm & 2pm–5pm
Tuesday 9am–1pm & 2pm–5pm
Wednesday 9am–1pm & 2pm–5pm
Thursday 9am–1pm
Friday 9am–1pm & 2pm–5pm

Rathangan Medical Centre,
New St,
Rathangan,
Co. Kildare,
R51 CY51
Tel: 045 528088