Medical Doctors Form
These forms are for use by medical practitioners in Malta only and registered by the Malta Medical Council.
Unauthorised use can lead to prosecution under the relevant ordinance or legislation.
It is important that you log in with your EID Password and not with your CORP Login.
Ticket is self-explanatory. Please fill in all necessary details and in fields were no feedback needs to be inserted, just click on no. Just in case you shall need any assistance when submitting a referral ticket please do not hesitate to contact Fast Track Coordinator on 25452468/ 79707652 or send an e-mail to ftca.health@gov.mt. Always save the Ticket as Draft if you encounter any difficulties.
The completed form can either be taken by hand to Customer Care at MDH or forwarded as soft copy to customercare.mdh@gov.mt for vetting by a Consultant Urologist. A Schedule V card will then be issued and sent to the patient by post once application is approved.
(Referrals to Medicine, Surgery, other Specialities and Health Centres)