You can always press Enter⏎ to continue
Fit-to-Work Consultation
If you require a sick leave certificate or "Fit note" instead, please return to the start and select "Work Sick Leave"
START
1
Full Name
as it should appear on the certificate
First Name
Last Name
Previous
Next
Submit
Press
Enter
2
Date of Birth
*
This field is required.
-
Date
Day
Month
Year
Previous
Next
Submit
Press
Enter
3
Sex
*
This field is required.
Female
Male
Prefer not to say
Previous
Next
Submit
Press
Enter
4
Email
*
This field is required.
where the certificate will be delivered
Previous
Next
Submit
Press
Enter
5
Phone
*
This field is required.
Previous
Next
Submit
Press
Enter
6
I acknowledge that I do not hold any of the following roles for which fit-to-work notes cannot be provided: Any driving roles, motorsports drivers, HGV and bus drivers, taxi drivers, forklift drivers, ambulance drivers, crane operators, or work involving heights and scaffolding. Please confirm by selecting "I agree".
I agree
Previous
Next
Submit
Press
Enter
7
Please explain why you need a fit to start/return to work letter
*
This field is required.
Minimum 20 words
0/0
Previous
Next
Submit
Press
Enter
8
Your Workplace / Company name / Institution
*
This field is required.
Previous
Next
Submit
Press
Enter
9
Please describe your daily work activities
Previous
Next
Submit
Press
Enter
10
Do you have any pre-existing health conditions?
YES
NO
Previous
Next
Submit
Press
Enter
11
Please list any underlying health issues or past medical history:
Previous
Next
Submit
Press
Enter
12
Do you take any regular medications?
(Whether prescribed or purchased over the counter)
YES
NO
Previous
Next
Submit
Press
Enter
13
Please list any regular medication you take, whether prescribed or over-the-counter:
Previous
Next
Submit
Press
Enter
14
How far can you walk before you have to stop to catch your breath?
Few hundred yards
Up to 1 mile
Unlimited
Previous
Next
Submit
Press
Enter
15
Please provide details on anything that could impact your work:
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
16
Please attach a form of ID as proof of identification.
Accepted forms of ID include: photo of your driver's license, passport, work badge, residence permit, or military ID card.
Drag and drop files here
Select files to upload
Max. file size
: 20.4MB
Browse Files
Cancel
of
Previous
Next
Submit
Press
Enter
17
Take a Selfie
*
This field is required.
Please take a clear photo of your face for identity verification
Previous
Next
Submit
Press
Enter
18
Terms
*
This field is required.
Upon submitting your medical consultation, you acknowledge our Terms and Privacy Policy and consent to the following: - You are NOT seriously unwell with any of the following symptoms: chest pain, shortness of breath, unrelenting severe headache, worsening severe abdominal pain, loss of vision, thoughts of suicide, confusion, ongoing bleeding, unable to swallow fluids or saliva, loss of limb sensation or control, facial numbness or weakness, slurred speech. - You understand the questions in the questionnaire and answered them honestly. - The requested letter is solely for the individual with the provided name and details. - Medical Cert is not a replacement for a doctor's visit. You confirm you do not think you need to see a medical professional. - Medical Cert is not your primary doctor or GP, and the doctor issuing your certificate may be unable to access your NHS or regular GP medical records. - Medical Cert facilitates access to private medical letters and does not issue Med3 notes, which are obtainable through your NHS GP for UK government benefits. - Medical Cert is unable to process refunds once a medical letter has been written and sent to you. - If your symptoms persist or you have not fully recovered, you agree to consult with your regular doctor or GP for further medical advice. - I consent to having this website store my submitted information so they can respond to my inquiry.
I agree
Previous
Next
Submit
Press
Enter
19
Fit to Work Letter
Previous
Next
Submit
Press
Enter
20
My Products
prev
next
( X )
My Bag
1
My Bag
Back to list
Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
ORDER SUMMARY
Total cost
GBP
Fit-to-work assessment
If we are unable to issue your certificate for any reason you will receive a full refund.
£
39.00
+
Edit
Back
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Previous
Next
Submit
Press
Enter
21
Tags
Todo
In Progress
Done
Previous
Next
Submit
Press
Enter
Should be Empty:
Medical Certificates from medicalcert.co.uk
[Edit]
Question Label
1
of
21
See All
Go Back
Submit