Request for Appointment With Mr Paul Nolan Request for Appointment Name * Address * Date of Birth * Home Phone Number * Mobile Number * Email Address * GP Name and Practice Address * Brief History of Symptoms * What treatment have you had for this condition? * Have you had an MRI scan within the last 12 months? * Insurance Company. Membership Number. Authorisation Code * Please choose which day you wish to attend * Monday morning – Ulster Independent Clinic Wednesday morning – The Ulster Independent Clinic Thursday evening – The Ulster Independent Clinic Please click the submit button and our office will contact you as soon as possible.