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Submit a Request

Inpatient – Admission Approval Form

1Request
2Patient
3Clinical & Bed
4Review

Step 1 — Request Details

Requestor

The SVUH staff member requesting the bed.

Number we can reach you on for follow-up

Request type

Drives the Source picker below

Type the first letters of the sending hospital

Referring consultant

Accepting consultant (SVUH)

Pick from the SVUH consultant list. Name auto-fills. If the email isn't known, key it in — it will be persisted back to the practitioner record for future lookups.

Type the first letters of the consultant's name

Email (must end @svhg.ie)

Step 1 of 4