• Sport Event Medical Certificate

    Health screening application form
  • Complete the below application form for your Sport Event Medical Certificate which is completed for a charge of £50 (additional £10 per certificate if more than one required).

    Any queries please email: sporteventcertificate@gmail.com

  • Personal Information

  •  - -
  • Physical condition

  • Have you ever suffered with any of the following?

  • Medical History

  • Terms and conditions

  • Disclaimer

    The purpose of a Sport Event Medical Certificate (further referred to as 'a certificate') is to fulfil the entry criteria for certain sporting events. A certificate will be issued based on you having declared no medical contraindication to you participating in a sporting event and on the assumption that the information that you have given is true and accurate. The issuing of a certificate should not be considered a medical examination. No further action will be taken regarding the information that you provide beyond consideration for the issuing of a certificate. The issuing of a certificate is not a guarantee against adverse events during or in preparation for any sporting event/activity. A certificate should not be considered medical indemnity or any form of insurance policy. In the issuing of a certificate the doctor does not take any responsibility for any adverse events as a result of participation in sporting events/activity. In participating in sporting events/activity you take responsibility for your own actions and you should be aware of your own physical limitations. You should prepare appropriately and stop to seek assistance should you feel unwell.
  • Privacy Policy

    We have a responsibility to protect and respect your privacy and look after your personal data which will only be used with valid reasons to do so. The personal data that we may collect includes your name, address, date of birth, telephone number, email address and health information submitted for your application. We receive personal data about you when you complete our online forms, contact us via email or if we contact you by phone. Personal data is used only to process your application for a sporting event medical certificate. We will retain your personal data only for as long as necessary. You have the right to object to our use of your personal data, or ask us to delete, remove or stop using it if there is no need for us to keep it. Your data will not be sold to, or shared with third parties without your consent. If you have any queries or concerns regarding the collection or retention of your personal data please email sporteventcertificate@gmail.com
  • Completion of Sport Event Medical Certificate

    On submission of this form you will be sent an email with payment details (please check your junk if you have not received within a few minutes). This health screening application will not be reviewed until the payment of £50 has been received (if more than one event certificate is required these will be charged at £10 each in addition to the initial £50 - please note this is not automated on the reply email so please make correct payment). On reviewing the information submitted, the doctor will make a decision as to whether they can issue a Sporting Event Medical Certificate which will then be emailed to you. On some occasions they may require some clarification in which case they will contact you by phone or by email. In the event that they are still unable to issue a certificate 50% of the fee paid will be refunded. Your bank details will be requested for the purposes of the refund but will not be retained beyond the processing of the refund. No refunds will be issued once a certificate is issued for whatever reason. Your certificate will be valid for 12 months from the date of issue. If there is a change in your health situation prior to your planned even you should seek another certificate to confirm the appropriateness of participation in a sport event.
  • Issuing of certificate

  • It is usually imperative that the specific certificate is required for individual events.

    We have approved certificates for a number of sporting events. You can select for the completion of one of these or the issue of a generic Sport Event Medical Certificate. If your event is not listed please select other and advise of the event. We will then source the appropriate certificate. If, in the unlikely event that an alternative certificate/clarification is required by an event/organiser/agent this will be completed free of charge - please contact sporteventcertificate@gmail.com
  • Thank you for completing this application. Please click submit and you will be sent an email with payment details. On receipt of payment your application will be reviewed in order to process your Sport Event Medical Certificate.

  • Should be Empty: